PRACTICE RESOURCES
Dedicated Support
LEQVIO® Service Center
The LEQVIO Service Center provides simple, reliable, and supportive solutions to help your patients start and stay on LEQVIO.
Your single point of contact is a dedicated specialist who can handle all your inquiries and requests for LEQVIO. Reach out to your dedicated Access Specialist for:
- Insurance coverage review
- Billing & coding information
- Patient affordability support
Call 1-833-LEQVIO2 (1-833-537-8462) M-F 8:00 AM to 8:00 PM (ET) to get started with the LEQVIO Service Center.
Novartis Access & Reimbursement Expert
- Offers resources and educational information on acquisition and billing & coding
- Available for in-office visits or by phone
- Ask your LEQVIO Sales Specialist or your dedicated LEQVIO Service Center specialist for their contact information
Sales Specialist
Get in touch with a sales specialist for support with product details, acquisition options, and co-pay assistance. Sales specialists do not have access to patient-level data.
Billing & Coding
LEQVIO Billing & Coding Information
Find the codes you need to file a claim
| Healthcare Common Procedure Coding System Level II Code1,2 | J1306 - Injection, inclisiran, 1 mg;
JZ modifier: Effective July 1, 2023, providers and suppliers are required to report the JZ modifier on all claims that bill for drugs from single-dose containers that are separately payable under Medicare Part B when there are no discarded amounts. TZ modifier: Starting January 1, 2025, the updated CMS guidance requires 340B covered entities to only report the TB modifier on claims for products acquired through the 340B program. Do not use the JG modifier for claims with dates of service after December 31, 2024. This update will impact Medicare providers and suppliers who bill for separately payable Part B drugs and biologics and participate in the 340B Pricing Program. |
| Current Procedural Terminology Code3* | 96372 - Therapeutic, Prophylactic, and Diagnostic Injection (specific substance or drug; subcutaneous or intramuscular) |
| International Classification of Diseases, 10th Revision, Clinical Modification | To find a full list of ICD-10 codes that may be relevant for LEQVIO, download our Billing & coding guide |
| National Drug Code4 | 10-digit: 0078-1000-60 11-digit: 00078-1000-60 |
| Place of Service (POS) Codes5 | 11 – Office 22 – On campus – Outpatient Hospital |
| Revenue Codes5 (hospital outpatient department administration only) | 0636 - Drugs requiring detailed coding 0250 - General pharmacy 0500 - General outpatient services 0510 - General clinic services |
To find a full list of codes that may be related to LEQVIO, download our Billing & Coding Guide.
Annotated CMS Claim Forms
To see example claim forms for LEQVIO, download our Annotated Claim Forms.
Download CMS-1500 Claim Form
Download CMS-1450 (UB-04) Claim Form
LEQVIO Claims and Coding Considerations
Better understand the importance of accurate billing and coding of LEQVIO through a review of codes, how to file a claim, and key differences in reimbursement by payer type.
*CPT © 2024 American Medical Association. All rights reserved.
The information herein is provided for educational purposes only. Novartis cannot guarantee insurance coverage or reimbursement. Coverage and reimbursement may vary significantly by payer, plan, patient, and setting of care. It is the sole responsibility of the health care provider to select the proper codes and ensure the accuracy of all statements used in seeking coverage and reimbursement for an individual patient.
Forms and Guides Library
Resources and forms for every step of the way
Enrollment
Patient Coverage
Financial Support
Acquisition
Download Alternate Site of Care Clinical Documentation Referral Checklist
Download LEQVIO Patient Management Tracker: Instructions for Use
Reimbursement
There's more to know about LEQVIO
Discover supportive resources available to help your patients get started on LEQVIO to help reduce LDL-C.
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