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.
- Once a patient is enrolled in BMS Access Support, we can review their insurance coverage
- A benefits review may help determine whether or not a medication is covered, if a PA is required, and estimated patient out-of-pocket costs
Prior Authorization (PA) and Appeals Assistance
- Use the BMS Access Map to identify plan-specific PA requirements
- View our forms and resources page for helpful support tools, including appeals letter templates and medical necessity letters
Annual Reverification
- Reverification of benefits is available upon request to confirm a patient’s benefits for the new year
- Connect with your local Access and Reimbursement Manager for more information
OPDIVO QVANTIG™
(nivolumab and hyaluronidase-nvhy)
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.
Explore codes on this page: ⬇HCPCS ⬇Revenue Codes ⬇CPT ⬇NDC ⬇ICD-10
Providers and suppliers are required to report the JW modifier on Part B drug claims for unused drugs and biologicals that are appropriately discarded. Also, providers and suppliers must document the amount of discarded drugs or biologicals in Medicare beneficiaries’ medical records.1
Providers and suppliers are required to report the JZ modifier to attest if there were no discarded amounts of drugs and biologicals.1
Healthcare Common Procedure Coding System (HCPCS) Codes2
Issued by CMS
| J9289 | Injection, nivolumab, 2 mg and hyaluronidase-nvhy |
Revenue Codes (for Hospital Use)3
| 0636 | Drugs requiring detailed coding |
| 0250 | Pharmacy (General) |
| 0331 | Chemotherapy administration, injected |
Current Procedural Terminology (CPT)4
| 96401 | Chemotherapy administration, SC or intramuscular; non-hormonal anti-neoplastic |
National Drug Codes (NDC)5
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.
| 00003-3120-01 | 300 mg nivolumab and 5,000 units hyaluronidase per 2.5 mL (120 mg/2,000 units per mL) single dose vial |
| 00003-6120-01 | 600 mg nivolumab and 10,000 units hyaluronidase per 5 mL (120 mg/2,000 units per mL) single dose vial |
International Classification of Diseases, Tenth Revision, Clinical Modification Diagnosis Codes (ICD-10-CM)6
| C43 | Malignant melanoma of skin |
| C43.0 | Malignant melanoma of lip |
| C43.1‡ | Malignant melanoma of eyelid, including canthus |
| C43.10 | Malignant melanoma of unspecified eyelid, including canthus |
| C43.11‡ | Malignant melanoma of right eyelid, including canthus |
| C43.111 | Malignant melanoma of right upper eyelid, including canthus |
| C43.112 | Malignant melanoma of right lower eyelid, including canthus |
| C43.12‡ | Malignant melanoma of left eyelid, including canthus |
| C43.121 | Malignant melanoma of left upper eyelid, including canthus |
| C43.122 | Malignant melanoma of left lower eyelid, including canthus |
| C43.2‡ | Malignant melanoma of ear and external auricular canal |
| C43.20 | Malignant melanoma of unspecified ear and external auricular canal |
| C43.21 | Malignant melanoma of right ear and external auricular canal |
| C43.22 | Malignant melanoma of left ear and external auricular canal |
| C43.3‡ | Malignant melanoma of other and unspecified parts of face |
| C43.30 | Malignant melanoma of unspecified part of face |
| C43.31 | Malignant melanoma of nose |
| C43.39 | Malignant melanoma of other parts of face |
| C43.4 | Malignant melanoma of scalp and neck |
| C43.5‡ | Malignant melanoma of trunk |
| C43.51 | Malignant melanoma of anal skin |
| C43.52 | Malignant melanoma of skin of breast |
| C43.59 | Malignant melanoma of other part of trunk |
| C43.6‡ | Malignant melanoma of upper limb, including shoulder |
| C43.60 | Malignant melanoma of unspecified upper limb, including shoulder |
| C43.61 | Malignant melanoma of right upper limb, including shoulder |
| C43.62 | Malignant melanoma of left upper limb, including shoulder |
| C43.7‡ | Malignant melanoma of lower limb, including hip |
| C43.70 | Malignant melanoma of unspecified lower limb, including hip |
| C43.71 | Malignant melanoma of right lower limb, including hip |
| C43.72 | Malignant melanoma of left lower limb, including hip |
| C43.8 | Malignant melanoma of overlapping sites of skin |
| C43.9 | Malignant melanoma of skin, unspecified |
| C21 | Malignant neoplasm of anus and anal canal |
| C21.0 | Malignant neoplasm of anus, unspecified |
| C21.1 | Malignant neoplasm of anal canal |
| C51 | Malignant neoplasm of vulva |
| C51.0 | Malignant neoplasm of labium majus |
| C51.1 | Malignant neoplasm of labium minus |
| C51.2 | Malignant neoplasm of clitoris |
| C51.9 | Malignant neoplasm of vulva, unspecified |
| C52 | Malignant neoplasm of vagina |
| C57 | Malignant neoplasm of other and unspecified female genital organs |
| C57.7 | Malignant neoplasm of other specified female genital organs |
| C57.8 | Malignant neoplasm of overlapping sites of female genital organs |
| C57.9 | Malignant neoplasm of female genital organ, unspecified |
| C60 | Malignant neoplasm of penis |
| C60.0 | Malignant neoplasm of prepuce |
| C60.1 | Malignant neoplasm of glans penis |
| C60.8 | Malignant neoplasm of overlapping sites of penis |
| C60.9 | Malignant neoplasm of penis, unspecified |
| C63 | Malignant neoplasm of other and unspecified male genital organs |
| C63.0‡ | Malignant neoplasm of epididymis |
| C63.00 | Malignant neoplasm of unspecified epididymis |
| C63.01 | Malignant neoplasm of right epididymis |
| C63.02 | Malignant neoplasm of left epididymis |
| C63.1‡ | Malignant neoplasm of spermatic cord |
| C63.10 | Malignant neoplasm of unspecified spermatic cord |
| C63.11 | Malignant neoplasm of right spermatic cord |
| C63.12 | Malignant neoplasm of left spermatic cord |
| C63.2 | Malignant neoplasm of scrotum |
| C63.7 | Malignant neoplasm of other specified male genital organs |
| C63.8 | Malignant neoplasm of overlapping sites of male genital organs |
| C63.9 | Malignant neoplasm of male genital organ, unspecified |
| Z51.12 | Encounter for antineoplastic immunotherapy |
| C33 | Malignant neoplasm of trachea |
| C34 | Malignant neoplasm of bronchus and lung |
| C34.0‡ | Malignant neoplasm of main bronchus, carina, and hilus of lung |
| C34.00 | Malignant neoplasm of unspecified main bronchus |
| C34.01 | Malignant neoplasm of right main bronchus |
| C34.02 | Malignant neoplasm of left main bronchus |
| C34.1‡ | Malignant neoplasm of upper lobe, bronchus or lung |
| C34.10 | Malignant neoplasm of upper lobe, unspecified bronchus or lung |
| C34.11 | Malignant neoplasm of upper lobe, right bronchus or lung |
| C34.12 | Malignant neoplasm of upper lobe, left bronchus or lung |
| C34.2 | Malignant neoplasm of middle lobe, bronchus or lung |
| C34.3‡ | Malignant neoplasm of lower lobe, bronchus or lung |
| C34.30 | Malignant neoplasm of lower lobe, unspecified bronchus or lung |
| C34.31 | Malignant neoplasm of lower lobe, right bronchus or lung |
| C34.32 | Malignant neoplasm of lower lobe, left bronchus or lung |
| C34.8‡ | Malignant neoplasm of overlapping sites of bronchus and lung |
| C34.80 | Malignant neoplasm of overlapping sites of unspecified bronchus and lung |
| C34.81 | Malignant neoplasm of overlapping sites of right bronchus and lung |
| C34.82 | Malignant neoplasm of overlapping sites of left bronchus and lung |
| C34.9‡ | Malignant neoplasm of unspecified part of bronchus or lung |
| C34.90 | Malignant neoplasm of unspecified part of unspecified bronchus or lung |
| C34.91 | Malignant neoplasm of unspecified part of right bronchus or lung |
| C34.92 | Malignant neoplasm of unspecified part of left bronchus or lung |
| Z51.12 | Encounter for antineoplastic immunotherapy |
| C64 | Malignant neoplasm of kidney, except renal pelvis |
| C64.1 | Malignant neoplasm of right kidney, except renal pelvis |
| C64.2 | Malignant neoplasm of left kidney, except renal pelvis |
| C64.9 | Malignant neoplasm of unspecified kidney, except renal pelvis |
| C65 | Malignant neoplasm of renal pelvis |
| C65.1 | Malignant neoplasm of right renal pelvis |
| C65.2 | Malignant neoplasm of left renal pelvis |
| C65.9 | Malignant neoplasm of unspecified renal pelvis |
| Z51.12 | Encounter for antineoplastic immunotherapy |
| C00 | Malignant neoplasm of lip |
| C00.0 | Malignant neoplasm of external upper lip |
| C00.1 | Malignant neoplasm of external lower lip |
| C00.2 | Malignant neoplasm of external lip, unspecified |
| C00.3 | Malignant neoplasm of upper lip, inner aspect |
| C00.4 | Malignant neoplasm of lower lip, inner aspect |
| C00.5 | Malignant neoplasm of lip, unspecified, inner aspect |
| C00.6 | Malignant neoplasm of commissure of lip, unspecified |
| C00.8 | Malignant neoplasm of overlapping sites of lip |
| C00.9 | Malignant neoplasm of lip, unspecified |
| C01 | Malignant neoplasm of base of tongue |
| C02 | Malignant neoplasm of other and unspecified parts of tongue |
| C02.0 | Malignant neoplasm of dorsal surface of tongue |
| C02.1 | Malignant neoplasm of border of tongue |
| C02.2 | Malignant neoplasm of ventral surface of tongue |
| C02.3 | Malignant neoplasm of anterior two-thirds of tongue, part unspecified |
| C02.4 | Malignant neoplasm of lingual tonsil |
| C02.8 | Malignant neoplasm of overlapping sites of tongue |
| C02.9 | Malignant neoplasm of tongue, unspecified |
| C03 | Malignant neoplasm of gum |
| C03.0 | Malignant neoplasm of upper gum |
| C03.1 | Malignant neoplasm of lower gum |
| C03.9 | Malignant neoplasm of gum, unspecified |
| C04 | Malignant neoplasm of floor of mouth |
| C04.0 | Malignant neoplasm of anterior floor of mouth |
| C04.1 | Malignant neoplasm of lateral floor of mouth |
| C04.8 | Malignant neoplasm of overlapping sites of floor of mouth |
| C04.9 | Malignant neoplasm of floor of mouth, unspecified |
| C05 | Malignant neoplasm of palate |
| C05.0 | Malignant neoplasm of hard palate |
| C05.1 | Malignant neoplasm of soft palate |
| C05.2 | Malignant neoplasm of uvula |
| C05.8 | Malignant neoplasm of overlapping sites of palate |
| C05.9 | Malignant neoplasm of palate, unspecified |
| C06 | Malignant neoplasm of other and unspecified parts of mouth |
| C06.0 | Malignant neoplasm of cheek mucosa |
| C06.1 | Malignant neoplasm of vestibule of mouth |
| C06.2 | Malignant neoplasm of retromolar area |
| C06.8‡ | Malignant neoplasm of overlapping sites of other and unspecified parts of mouth |
| C06.80 | Malignant neoplasm of overlapping sites of unspecified parts of mouth |
| C06.89 | Malignant neoplasm of overlapping sites of other parts of mouth |
| C06.9 | Malignant neoplasm of mouth, unspecified |
| C09 | Malignant neoplasm of tonsil |
| C09.0 | Malignant neoplasm of tonsillar fossa |
| C09.1 | Malignant neoplasm of tonsillar pillar (anterior) (posterior) |
| C09.8 | Malignant neoplasm of overlapping sites of tonsil |
| C09.9 | Malignant neoplasm of tonsil, unspecified |
| C10 | Malignant neoplasm of oropharynx |
| C10.0 | Malignant neoplasm of vallecula |
| C10.1 | Malignant neoplasm of anterior surface of epiglottis |
| C10.2 | Malignant neoplasm of lateral wall of oropharynx |
| C10.3 | Malignant neoplasm of posterior wall of oropharynx |
| C10.4 | Malignant neoplasm of branchial cleft |
| C10.8 | Malignant neoplasm of overlapping sites of oropharynx |
| C12 | Malignant neoplasm of pyriform sinus |
| C13 | Malignant neoplasm of hypopharynx |
| C13.0 | Malignant neoplasm of postcricoid region |
| C13.1 | Malignant neoplasm aryepiglottic fold, hypopharyngeal aspect |
| C13.2 | Malignant neoplasm of posterior wall of hypopharynx |
| C13.8 | Malignant neoplasm of overlapping sites of hypopharynx |
| C13.9 | Malignant neoplasm of hypopharynx, unspecified |
| C14 | Malignant neoplasm of other and ill-defined sites in the lip, oral cavity and pharynx |
| C14.0 | Malignant neoplasm of pharynx, unspecified |
| C14.2 | Malignant neoplasm of Waldeyer’s ring |
| C14.8 | Malignant neoplasm of overlapping sites of lip, oral cavity and pharynx |
| C32 | Malignant neoplasm of larynx |
| C32.0 | Malignant neoplasm of glottis |
| C32.1 | Malignant neoplasm of supraglottis |
| C32.2 | Malignant neoplasm of subglottis |
| C32.3 | Malignant neoplasm of laryngeal cartilage |
| C32.8 | Malignant neoplasm of overlapping sites of larynx |
| C32.9 | Malignant neoplasm of larynx, unspecified |
| C76 | Malignant neoplasm of other and ill-defined sites |
| C76.0 | Malignant neoplasm of head, face and neck |
| Z51.12 | Encounter for antineoplastic immunotherapy |
| C65 | Malignant neoplasm of renal pelvis |
| C65.1 | Malignant neoplasm of right renal pelvis |
| C65.2 | Malignant neoplasm of left renal pelvis |
| C65.9 | Malignant neoplasm of unspecified renal pelvis |
| C66 | Malignant neoplasm of ureter |
| C66.1 | Malignant neoplasm of right ureter |
| C66.2 | Malignant neoplasm of left ureter |
| C66.9 | Malignant neoplasm of unspecified ureter |
| C67 | Malignant neoplasm of bladder |
| C67.0 | Malignant neoplasm of trigone of bladder |
| C67.1 | Malignant neoplasm of dome of bladder |
| C67.2 | Malignant neoplasm of lateral wall of bladder |
| C67.3 | Malignant neoplasm of anterior wall of bladder |
| C67.4 | Malignant neoplasm of posterior wall of bladder |
| C67.5 | Malignant neoplasm of bladder neck |
| C67.6 | Malignant neoplasm of ureteric orifice |
| C67.8 | Malignant neoplasm of overlapping sites of bladder |
| C67.9 | Malignant neoplasm of bladder, unspecified |
| C68 | Malignant neoplasm of other and unspecified urinary organs |
| C68.0 | Malignant neoplasm of urethra |
| C68.8 | Malignant neoplasm of overlapping sites of urinary organs |
| C68.9 | Malignant neoplasm of urinary organ, unspecified |
| Z51.12 | Encounter for antineoplastic immunotherapy |
| C18 | Malignant neoplasm of colon |
| C18.0 | Malignant neoplasm of cecum |
| C18.1 | Malignant neoplasm of appendix |
| C18.2 | Malignant neoplasm of ascending colon |
| C18.3 | Malignant neoplasm of hepatic flexure |
| C18.4 | Malignant neoplasm of transverse colon |
| C18.5 | Malignant neoplasm of splenic flexure |
| C18.6 | Malignant neoplasm of descending colon |
| C18.7 | Malignant neoplasm of sigmoid colon |
| C18.8 | Malignant neoplasm of overlapping sites of colon |
| C18.9 | Malignant neoplasm of colon, unspecified |
| C19 | Malignant neoplasm of rectosigmoid junction |
| C20 | Malignant neoplasm of rectum |
| Z51.12 | Encounter for antineoplastic immunotherapy |
| C22 | Malignant neoplasm of liver and intrahepatic bile ducts |
| C22.0 | Liver cell carcinoma (hepatocellular carcinoma, hepatoma) |
| C22.8 | Malignant neoplasm of liver, primary, unspecified as to type |
| Z51.12 | Encounter for antineoplastic immunotherapy |
Advanced ESCC
| C15 | Malignant neoplasm of esophagus |
| C15.3 | Malignant neoplasm of upper third of esophagus |
| C15.4 | Malignant neoplasm of middle third of esophagus |
| C15.5 | Malignant neoplasm of lower third of esophagus |
| C15.8 | Malignant neoplasm of overlapping sites of esophagus |
| C15.9 | Malignant neoplasm of esophagus, unspecified |
Adjuvant Treatment of EC or GEJC
| C15 | Malignant neoplasm of esophagus |
| C15.3 | Malignant neoplasm of upper third of esophagus |
| C15.4 | Malignant neoplasm of middle third of esophagus |
| C15.5 | Malignant neoplasm of lower third of esophagus |
| C15.8 | Malignant neoplasm of overlapping sites of esophagus |
| C15.9 | Malignant neoplasm of esophagus, unspecified |
| C16 | Malignant neoplasm of stomach (gastroesophageal junction) |
| C16.0 | Malignant neoplasm of cardia Malignant neoplasm of cardiac orifice Malignant neoplasm of cardio-esophageal junction Malignant neoplasm of esophagus and stomach Malignant neoplasm of gastro-esophageal junction |
1L Metastatic ESCC
| C15 | Malignant neoplasm of esophagus |
| C15.3 | Malignant neoplasm of upper third of esophagus |
| C15.4 | Malignant neoplasm of middle third of esophagus |
| C15.5 | Malignant neoplasm of lower third of esophagus |
| C15.8 | Malignant neoplasm of overlapping sites of esophagus |
| C15.9 | Malignant neoplasm of esophagus, unspecified |
Advanced or Metastatic Gastric, GEJ, and Esophageal Adenocarcinoma
| C15 | Malignant neoplasm of esophagus |
| C15.3 | Malignant neoplasm of upper third of esophagus |
| C15.4 | Malignant neoplasm of middle third of esophagus |
| C15.5 | Malignant neoplasm of lower third of esophagus |
| C15.8 | Malignant neoplasm of overlapping sites of esophagus |
| C15.9 | Malignant neoplasm of esophagus, unspecified |
| C16 | Malignant neoplasm of stomach (gastroesophageal junction) |
| C16.0 | Malignant neoplasm of cardia Malignant neoplasm of cardiac orifice Malignant neoplasm of cardio-esophageal junction Malignant neoplasm of esophagus and stomach Malignant neoplasm of gastro-esophageal junction |
| C16.1 | Malignant neoplasm of fundus of stomach |
| C16.2 | Malignant neoplasm of body of stomach |
| C16.3 | Malignant neoplasm of pyloric antrum |
| C16.4 | Malignant neoplasm of pylorus |
| C16.5 | Malignant neoplasm of lesser curvature of stomach, unspecified |
| C16.6 | Malignant neoplasm of greater curvature of stomach, unspecified |
| C16.8 | Malignant neoplasm of overlapping sites of stomach |
| C16.9 | Malignant neoplasm of stomach, unspecified |
| Z51.12 | Encounter for antineoplastic immunotherapy |
Coding for OPDIVO QVANTIG is dependent on the insurer and the care setting in which the drug will be administered. Oncology practices 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 OPDIVO QVANTIG.
*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 information 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.
†CPT codes and descriptions only are ©2025 by American Medical Association (AMA). All rights reserved. The AMA assumes no liability for data contained or not contained herein. CPT is a registered trademark of the American Medical Association.
‡This is a category code and is invalid for stand-alone use. Please select one of the expanded codes listed below.
References:
- Centers for Medicare & Medicaid Services. Discarded Drugs and Biologicals – JW Modifier and JZ Modifier Policy. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalOutpatientPPS/Downloads/JW-Modifier-FAQs.pdf. Accessed January 27, 2026.
- American Medical Association. HCPCS Level II Expert 2025. American Medical Association; 2024.
- National Uniform Billing Committee (NUBC). Official UB-04 Data Specifications Manual 2020. Chicago, IL: American Hospital Association; 2020.
- American Medical Association. CPT 2025 Professional Edition. American Medical Association; 2024.
- OPDIVO QVANTIG [package insert]. Princeton, NJ: Bristol-Myers Squibb Company.
- Centers for Medicare & Medicaid Services. 2026 ICD-10-CM tabular list of diseases and injuries. https://www.cms.gov/files/zip/2026-code-tables-tabular-and-index.zip. Accessed January 27, 2026.
OPDIVO QVANTIG may be purchased through the distributors listed below.
Physician Offices
| Authorized Distributor | Phone & Fax Orders |
| Besse Medical > | Phone: 1-877-711-5469
|
| Cardinal Health Specialty Pharmaceutical Distribution > | Phone: 1-877-453-3972
|
| CuraScript Specialty Distribution > | Phone: 1-877-599-7748
|
| HyGen Pharmaceuticals Specialty Division > | Phone: 1-877-630-9198
|
| 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 OPDIVO QVANTIG from the distributors listed above.
Hospitals and Infusion Centers
| Authorized 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
|
| DMS Pharmaceutical Group, Inc. > | Phone: 1-877-788-1100
Fax: 1-847-518-1105
|
| HyGen Pharmaceuticals Specialty Division > | Phone: 1-877-630-9198
|
| 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
|
Above information is accurate as of 01/26.
The OPDIVO QVANTIG distribution program includes extended payment terms to Bristol Myers Squibb authorized OPDIVO QVANTIG distributors. Healthcare providers and institutions should contact their OPDIVO QVANTIG distributor to understand specific payment terms that may be available to them from their distributor.
Please see U.S. Full Prescribing Information for OPDIVO QVANTIG.
FDA Approval Letters as Posted by the FDA:
OPDIVO Qvantig, as monotherapy, is indicated for the adjuvant treatment of adult and pediatric patients 12 years and older who weigh 30 kg or greater with completely resected Stage IIB, Stage IIC, Stage III, or Stage IV melanoma – Approved on 12/27/2024
OPDIVO Qvantig, as monotherapy, is indicated for the treatment of adult and pediatric patients 12 years and older who weigh 30 kg or greater with unresectable or metastatic melanoma following treatment with intravenous nivolumab and ipilimumab combination therapy – Approved on 12/27/2024
Limitations of Use: OPDIVO Qvantig is not indicated in combination with ipilimumab for the treatment of unresectable or metastatic melanoma.
OPDIVO Qvantig, in combination with platinum-doublet chemotherapy, is indicated as neoadjuvant treatment of adult patients with resectable (tumors ≥4 cm or node positive) NSCLC – Approved on 12/27/2024
OPDIVO Qvantig, in combination with platinum-doublet chemotherapy, is indicated for the neoadjuvant treatment of adult patients with resectable (tumors ≥4 cm or node positive) NSCLC and no known epidermal growth factor receptor (EGFR) mutations or anaplastic lymphoma kinase (ALK) rearrangements, followed by OPDIVO Qvantig as monotherapy in the adjuvant setting after surgical resection – Approved on 12/27/2024
OPDIVO Qvantig, as monotherapy, is indicated for the treatment of adult patients with metastatic NSCLC with progression on or after platinum-based chemotherapy. Patients with EGFR or ALK genomic tumor aberrations should have disease progression on FDA-approved therapy for these aberrations prior to receiving OPDIVO Qvantig – Approved on 12/27/2024
Limitations of Use: OPDIVO Qvantig is not indicated in combination with ipilimumab for the treatment of metastatic NSCLC.
OPDIVO Qvantig, as monotherapy, is indicated for the first-line treatment of adult patients with intermediate or poor risk advanced renal cell carcinoma (RCC) following treatment with intravenous nivolumab and ipilimumab combination therapy – Approved on 12/27/2024
Limitations of Use: OPDIVO Qvantig is not indicated in combination with ipilimumab for the treatment of renal cell carcinoma.
OPDIVO Qvantig, in combination with cabozantinib, is indicated for the first line treatment of adult patients with advanced renal cell carcinoma (RCC) – Approved on 12/27/2024
OPDIVO Qvantig, as monotherapy, is indicated for the treatment of adult patients with advanced renal cell carcinoma (RCC) who have received prior anti-angiogenic therapy – Approved on 12/27/2024
OPDIVO Qvantig, as monotherapy, is indicated for the treatment of adult patients with recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN) with disease progression on or after platinum-based therapy – Approved on 12/27/2024
OPDIVO Qvantig, as monotherapy, is indicated for the adjuvant treatment of adult patients with urothelial carcinoma (UC) who are at high risk of recurrence after undergoing radical resection of UC – Approved on 12/27/2024
OPDIVO Qvantig, in combination with cisplatin and gemcitabine, is indicated for the first-line treatment of adult patients with unresectable or metastatic urothelial carcinoma – Approved on 12/27/2024
OPDIVO Qvantig, as monotherapy, is indicated for the treatment of adult patients with locally advanced or metastatic UC who:
- have disease progression during or following platinum-containing chemotherapy.
- have disease progression within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy.
– Approved on 12/27/2024
OPDIVO Qvantig, as monotherapy, is indicated for the treatment of adult and pediatric patients 12 years and older who weigh 30 kg or greater with unresectable or metastatic microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) colorectal cancer (CRC), following treatment with intravenous nivolumab and ipilimumab combination therapy – Approved on 10/27/2025
Limitations of Use: OPDIVO Qvantig is not indicated in combination with ipilimumab for the treatment of unresectable or metastatic MSI-H or dMMR metastatic CRC.
OPDIVO Qvantig, as monotherapy, is indicated for the treatment of adult and pediatric patients 12 years and older who weigh 30 kg or greater with microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) metastatic colorectal cancer (CRC) that has progressed following treatment with a fluoropyrimidine, oxaliplatin, and irinotecan – Approved on 10/27/2025
OPDIVO Qvantig, as monotherapy, is indicated for the first-line treatment of adult patients with unresectable or metastatic hepatocellular carcinoma (HCC) following treatment with intravenous nivolumab and ipilimumab combination therapy – Approved on 10/27/2025
OPDIVO Qvantig, as monotherapy, is indicated for the treatment of adult patients with unresectable or metastatic hepatocellular carcinoma (HCC) who have been previously treated with sorafenib following treatment with intravenous nivolumab and ipilimumab combination therapy – Approved on 10/27/2025
Limitations of Use: OPDIVO Qvantig is not indicated in combination with ipilimumab for the treatment of patients with unresectable or metastatic HCC.
OPDIVO Qvantig, in combination with fluoropyrimidine- and platinum-containing chemotherapy, is indicated for the treatment of adult patients with advanced or metastatic gastric cancer, gastroesophageal junction cancer, and esophageal adenocarcinoma whose tumors express PD-L1 (≥1) – Approved on 05/23/2025
OPDIVO QVANTIG, in combination with fluoropyrimidine- and platinum-containing chemotherapy, is indicated for the first line treatment of adult patients with unresectable advanced or metastatic esophageal squamous cell carcinoma (ESCC) whose tumors express PD-L1 (≥1) – Approved on 05/23/2025
Limitations of Use: OPDIVO QVANTIG is not indicated in combination with ipilimumab for the treatment of patients with unresectable advanced or metastatic ESCC.
OPDIVO QVANTIG as monotherapy, is indicated for the adjuvant treatment of completely resected esophageal or gastroesophageal junction cancer with residual pathologic disease in adult patients who have received neoadjuvant chemoradiotherapy (CRT) – Approved on 12/27/2024
OPDIVO QVANTIG as monotherapy, is indicated for the treatment of adult patients with unresectable advanced, recurrent, or metastatic esophageal squamous cell carcinoma (ESCC) after prior fluoropyrimidine- and platinum-based chemotherapy – Approved on 12/27/2024
Claim Forms for Outpatient Administration
Sample CMS-1500
Physician Office
Sample UB-04/CMS-1450
Hospital Outpatient
See Payer Policy Details
Learn about payer information by state for applicable treatments.
