Benefits Reviews
Codes and Coverage
Supporting patient access
BMS Access Support® may help support patient access by conducting benefits reviews and offering prior authorization and appeals process assistance for enrolled patients. Additionally, the information below provides product-specific billing and diagnosis codes, reimbursement and coding guides, distribution information, and additional coverage support offerings. To view available coding and coverage information, please select your patient’s prescribed medication.
Additional eligibility criteria and terms may apply. Bristol Myers Squibb and its agents make no guarantee regarding reimbursement for any service or item.
The accurate completion of reimbursement- or coverage-related documentation is the responsibility of the healthcare provider and patient. Bristol Myers Squibb and its agents make no guarantee regarding reimbursement for any service or item.
National Drug Codes (NDC)1
Issued by the FDA
Note: Payers require the submission of the 11-digit NDC on healthcare claim forms. Please use the 11-digit codes shown here
| 59572-0705-30 | 50-mg tablets; one bottle containing 30 tablets |
| 59572-0710-30 | 100-mg tablets; one bottle containing 30 tablets |
International Classification of Diseases, Tenth Revision, Clinical Modification Diagnosis Codes (ICD-10-CM)2
| C92 | Myeloid Leukemia |
| C92.0 | Acute myeloblastic leukemia |
| C92.00 | Acute myeloblastic leukemia, not having achieved remission |
| C92.01 | Acute myeloblastic leukemia, in remission |
| C92.02 | Acute myeloblastic leukemia, in relapse |
Coding for IDHIFA is dependent on the insurer and the care setting in which the drug will be administered. Healthcare providers need to make coding decisions based on the diagnosis and treatment of each patient and the specific insurer requirements.
Please see U.S. Full Prescribing Information for IDHIFA, including Boxed WARNING.
*Healthcare providers should code healthcare claims based upon the service that is rendered, the patient’s medical record, the coding requirements of each health insurer, and best coding practices. Coding guidance provided under this heading does not provide a guarantee of reimbursement and should be considered together with all applicable coding guidance and standards. All of the coding information presented by this website is applicable to outpatient procedures only.
References:
- IDHIFA (enasidenib) [package insert]. Princeton, NJ: Bristol-Myers Squibb Company.
- Centers for Medicare & Medicaid Services. ICD-10-CM tabular list of diseases and injuries. https://www.cms.gov/medicare/coding-billing/icd-10-codes/2023-icd-10-cm. Accessed August 3, 2023.
IDHIFA may be purchased through the distributors listed below.
Physician Offices
| Authorized Distributor | Phone & Fax Orders |
| Cardinal Health Specialty Pharmaceutical Distribution > | Phone: 1-877-453-3972
|
| CuraScript Specialty Distribution > | Phone: 1-877-599-7748
|
| McKesson Specialty Health > | Phone: 1-800-482-6700
|
| Morris & Dickson Specialty > | Phone: 1-800-710-6100
Fax: 1-318-524-3096
|
| Oncology Supply > | Phone: 1-800-633-7555
|
For offices that prefer to use the services of a specialty pharmacy, specialty pharmacies can obtain IDHIFA from the distributors listed above.
Hospitals and Infusion Centers
| Specialty Distributor | Phone & Fax Orders |
| ASD Healthcare > | Phone: 1-800-746-6273
Fax: 1-800-547-9413
|
| Cardinal Health Specialty Pharmaceutical Distribution > | Phone: 1-866-677-4844
Fax: 1-614-553-6301
|
| McKesson Plasma and Biologics > | Phone: 1-877-625-2566
Fax: 1-888-752-7626
|
| Morris & Dickson Specialty > | Phone: 1-800-710-6100
Fax: 1-318-524-3096
|
Puerto Rico Hospitals and Clinics
| Authorized Distributor | Phone & Fax Orders |
| AmerisourceBergen Puerto Rico > | Phone: 1-844-222-2273 |
| Cardinal Puerto Rico (Borschow) > | Phone: 1-787-625-4200
|
| Cesar Castillo, Inc. > | Phone: 1-787-641-5242 (Hospitals)
Phone: 1-787-641-5082 (Specialty Pharmacies)
Fax: 1-787-999-1614
|
Above information is accurate as of 1/26.
The IDHIFA distribution program includes extended payment terms to Bristol Myers Squibb authorized IDHIFA distributors. Healthcare providers and institutions should contact their IDHIFA distributor to understand specific payment terms that may be available to them from their distributor.
Please see U.S. Full Prescribing Information for IDHIFA, including Boxed WARNING.
FDA Approval Letters as Posted by the FDA:
For the treatment of adult patients with relapsed or refractory acute myeloid leukemia (AML) with an isocitrate dehydrogenase-2 (IDH2) mutation as detected by an FDA-approved test
Please see U.S. Full Prescribing Information for IDHIFA, including Boxed WARNING.
Claim Forms for Outpatient Administration
Blank CMS-1500
Physician Office
Blank UB-04/CMS-1450
Hospital Outpatient
See Payer Policy Details
Learn about payer information by state for applicable treatments.
