This information is intended for U.S. healthcare professionals and/or
healthcare professionals involved in healthcare reimbursement.
This site is intended for U.S. residents 18 years of age or older.
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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.
Read more about our coverage support offerings
Benefits Reviews
- Once a patient is enrolled in BMS Access Support, we can review their insurance coverage and provide a summary of benefits within approximately 24 hours*
- 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
*BMS Access Support Data - Benefits review. Accessed August 2022.
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
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.
Filter results by:
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.
| 59572-0205-17 Copy | 50 mg/individual blister packs of 1 capsule |
| 59572-0205-14 Copy | 50 mg/individual blister packs of 28 capsules |
| 59572-0210-15 Copy | 100 mg/individual blister packs of 28 capsules |
| 59572-0215-13 Copy | 150 mg/individual blister packs of 28 capsules |
| 59572-0220-16 Copy | 200 mg/individual blister packs of 28 capsules |
International Classification of Diseases, Tenth Revision, Clinical Modification Diagnosis Codes (ICD-10-CM)
| Multiple Myeloma ICD-10 Codes2 | |
| C90 Copy | Multiple myeloma and malignant plasma cell neoplasms |
| C90.0 Copy | Multiple myeloma |
| Leprosy (Hansen's disease) ICD-10 Codes2 | |
| A30 | Leprosy (Hansen's disease) |
| A30.0 Copy | Indeterminate leprosy |
| A30.1 Copy | Tuberculoid leprosy |
| A30.2 Copy | Borderline tuberculoid leprosy |
| A30.3 Copy | Borderline leprosy |
| A30.4 Copy | Borderline lepromatous leprosy |
| A30.5 Copy | Lepromatous leprosy |
| A30.8 Copy | Other forms of leprosy |
| A30.9 Copy | Leprosy, unspecified |
Coding for THALOMID 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 THALOMID, 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:
- THALOMID (thalidomide) [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.
Prescribers and pharmacies must be certified with the THALOMID REMS® program by enrolling and complying with the REMS requirements; pharmacies must only dispense to patients who are authorized to received THALOMID. 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 |
|---|---|---|
| Absolute Pharmacy | 1-787-892-8700 | 1-787-496-1010 |
| AcariaHealth Pharmacy | 1-866-458-9246 | 1-866-458-9245 |
| Accredo Specialty Pharmacy | 1-877-732-3431 | 1-800-590-1021 |
| ACS Advanced Care Scripts | 1-877-985-6337 | 1-866-679-7131 |
| AllianceRx Walgreens Prime | 1-888-347-3416 | 1-877-231-8302 |
| Amber Specialty Pharmacy | 1-888-370-1724 | 1-877-645-7514 |
| Axium Healthcare Puerto Rico | 1-787-780-7200 | 1-800-546-2163 | Biologics by McKesson | 1-800-850-4306 | 1-800-823-4506 |
| Biomatrix | 1-888-662-6779 | 1-877-800-4790 |
| BioPlus Specialty Pharmacy | 1-888-292-0744 | 1-800-269-5493 |
| CareMed Specialty Pharmacy | 1-877-227-3405 | 1-877-542-2731 |
| CVS Specialty | 1-800-237-2767 | 1-800-323-2445 |
| Farmacia San Rafael | 1-787-724-3333 | 1-787-721-4165 |
| Humana Specialty Pharmacy | 1-800-486-2668 | 1-877-405-7940 |
| Kroger Specialty Pharmacy | 1-888-327-2962 | 1-888-315-3270 |
| Magellan Rx Pharmacy (ICORE) | 1-866-554-2673 | 1-866-364-2673 |
| Onco360 | 1-877-662-6633 | 1-877-662-6355 |
| Optum Specialty Pharmacy | 1-877-445-6874 | 1-866-306-5231 |
| RxCrossroads by McKesson (VA Dispensing) | 1-855-637-9433 | 1-855-637-9446 |
| Special Care Pharmacy Services | 1-787-781-4585 | 1-787-783-2951 |
| Upstate Pharmacy | 1-800-314-4655 | 1-800-314-7756 |
| US Bioservices | 1-877-757-0667 | 1-888-899-0067 |
Above information is accurate as of 12/23.
The THALOMID distribution program includes extended payment terms to Bristol Myers Squibb authorized THALOMID distributors. Healthcare providers and institutions should contact their THALOMID distributor to understand specific payment terms that may be available to them from their distributor.
Please see U.S. Full Prescribing Information for THALOMID, including Boxed WARNINGS.
FDA Approval Letters as Posted by the FDA:
For the treatment of patients with newly diagnosed multiple myeloma in combination with dexamethasone
View Letter
For the acute treatment of cutaneous manifestations of moderate to severe ENL (erythema nodosum leprosum)
Note: THALOMID is not indicated as monotherapy for such ENL treatment in the presence of moderate to severe neuritis.
For maintenance therapy for the prevention and suppression of the cutaneous manifestations of ENL recurrence
View LetterPlease see U.S. Full Prescribing Information for THALOMID, including Boxed WARNINGS.
