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
| 59572-0501-21 | 1 mg capsules, bottles of 21 |
| 59572-0501-00 | 1 mg capsules, bottles of 100 |
| 59572-0502-21 | 2 mg capsules, bottles of 21 |
| 59572-0502-00 | 2 mg capsules, bottles of 100 |
| 59572-0503-21 | 3 mg capsules, bottles of 21 |
| 59572-0503-00 | 3 mg capsules, bottles of 100 |
| 59572-0504-21 | 4 mg capsules, bottles of 21 |
| 59572-0504-00 | 4 mg capsules, bottles of 100 |
International Classification of Diseases, Tenth Revision, Clinical Modification Diagnosis Codes (ICD-10-CM)2
Multiple Myeloma ICD-10 Codes
| C90 | Multiple myeloma and malignant plasma cell neoplasms |
| C90.0 | Multiple myeloma |
| C90.00 | Multiple myeloma not having achieved remission |
| C90.01 | Multiple myeloma in remission |
| C90.02 | Multiple myeloma in relapse |
Kaposi’s Sarcoma (KS) ICD-10 Codes
| C46 | Kaposi’s sarcoma |
| C46.0 | Kaposi’s sarcoma of skin |
| C46.1 | Kaposi's sarcoma of soft tissue |
| C46.2 | Kaposi's sarcoma of palate |
| C46.3 | Kaposi's sarcoma of lymph nodes |
| C46.4 | Kaposi's sarcoma of gastrointestinal sites |
| C46.5 | Kaposi's sarcoma of lung |
| C46.50 | Kaposi's sarcoma of unspecified lung |
| C46.51 | Kaposi’s sarcoma of right lung |
| C46.52 | Kaposi’s sarcoma of left lung |
| C46.7 | Kaposi’s sarcoma of other sites |
| C46.9 | Kaposi’s sarcoma, unspecified |
Coding for POMALYST 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 POMALYST, including Boxed WARNINGS.
*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:
- POMALYST [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.
Prescribers and pharmacies must be certified with the POMALYST REMS® program by enrolling and complying with the REMS requirements; pharmacies must only dispense to patients who are authorized to receive POMALYST. The REMS-Pharmacy Network list includes specialty pharmacies that are contracted to fill prescriptions for restricted distribution programs for Bristol Myers Squibb.
Specialty Pharmacies
| Pharmacy | Phone & Fax Orders |
| Absolute Pharmacy | Phone: 1-787-892-8700
Fax: 1-787-496-1010
|
| AcariaHealth Pharmacy | Phone: 1-866-458-9246
Fax:1-866-458-9245
|
| Accredo Specialty Pharmacy | Phone: 1-877-732-3431
Fax: 1-800-590-1021
|
| ACS Advanced Care Scripts | Phone: 1-877-985-6337
Fax: 1-866-679-7131
|
| AllianceRx Walgreens Prime | Phone: 1-888-347-3416
Fax: 1-877-231-8302
|
| Amber Specialty Pharmacy | Phone: 1-888-370-1724
Fax: 1-877-645-7514
|
| Axium Healthcare Puerto Rico | Phone: 1-787-780-7200
Fax: 1-800-546-2163
|
| Biologics by McKesson | Phone: 1-800-850-4306
Fax: 1-800-823-4506
|
| Biomatrix | Phone: 1-888-662-6779
Fax: 1-877-800-4790
|
| BioPlus Specialty Pharmacy | Phone: 1-888-292-0744
Fax: 1-800-269-5493
|
| CareMed Specialty Pharmacy | Phone: 1-877-227-3405
Fax: 1-877-542-2731
|
| CVS Specialty | Phone: 1-800-237-2767
Fax: 1-800-323-2445
|
| Farmacia San Rafael | Phone: 1-787-724-3333
Fax: 1-787-721-4165
|
| Humana Specialty Pharmacy | Phone: 1-800-486-2668
Fax: 1-877-405-7940
|
| Kroger Specialty Pharmacy | Phone: 1-888-327-2962
Fax: 1-888-315-3270
|
| Magellan Rx Pharmacy (ICORE) | Phone: 1-866-554-2673
Fax: 1-866-364-2673
|
| Onco360 | Phone: 1-877-662-6633
Fax: 1-877-662-6355
|
| Optum Specialty Pharmacy | Phone: 1-877-445-6874
Fax: 1-866-306-5231
|
| RxCrossroads by McKesson (VA Dispensing) | Phone: 1-855-637-9433
Fax: 1-855-637-9446
|
| Special Care Pharmacy Services | Phone: 1-787-783-8579
Fax: 1-787-783-2951
|
| Upstate Pharmacy | Phone: 1-800-314-4655
Fax: 1-800-314-7756
|
| US Bioservices | Phone: 1-877-757-0667
Fax: 1-888-899-0067
|
Above information is accurate as of 01/26.
The POMALYST distribution program includes extended payment terms to Bristol Myers Squibb authorized POMALYST distributors. Healthcare providers and institutions should contact their POMALYST distributor to understand specific payment terms that may be available to them from their distributor.
Please see U.S. Full Prescribing Information for POMALYST, including Boxed WARNINGS.
FDA Approval Letters as Posted by the FDA:
In combination with dexamethasone, for treatment of patients with multiple myeloma who have received at least two prior therapies including lenalidomide and a proteasome inhibitor and have demonstrated disease progression on or within 60 days of completion of the last therapy
For the treatment of adult patients with AIDS-related Kaposi sarcoma (KS) after failure of highly active antiretroviral therapy (HAART) or in patients with KS who are HIV-negative†
†This indication is approved under accelerated approval based on overall response rate. Continued approval for this indication may be contingent upon verification and description of clinical benefit in a confirmatory trial(s).
Please see U.S. Full Prescribing Information for POMALYST, including Boxed WARNINGS.
See Payer Policy Details
Learn about payer information by state for applicable treatments.
