Financial FAQs

Is there a new billing code (J code) for Hizentra?
The CPT^®, HCPCS (Healthcare Common Procedural Coding System), and ICD-9-CM codes provided below are based on guidelines from the American Medical Association (AMA) or the Center for Medicare and Medicaid Services (CMS). The billing party is solely responsible for coding of services (eg, CPT^® coding). Because government and other third-party payor coding requirements change periodically, please verify current coding requirements directly with the payor being billed.

Medicare, Medicaid, and most insurers will cover Hizentra for primary immunodeficiency disease. Hizentra is reimbursed as a Medicare Part B/DME benefit. Medicaid reimbursement will vary by state. Specific benefit coverage varies by payor and provider contract.

The HCPCS codes are published and maintained by CMS. These codes are used to report drugs and procedures performed by the healthcare provider. CPT^® codes are published and maintained by the AMA.

HCPCS and CPT^® Codes

HCPCS Code	Description
J3490	Not otherwise classified drug
J3590	Not otherwise classified biologic
J7799	Use for Hizentra through December 31, 2010 (not otherwise classified drug, other than inhalation drugs, administered through DME)

CPT^® Code	Description
J96369	Subcutaneous infusion initial hour, including pump setup and establishment of subcutaneous infusion site(s)
J96370	Subcutaneous infusion additional hour
J96371	Additional pump setup with establishment of subcutaneous infusion site(s)

Ready-to-Use Hizentra Dosage Forms
Grams Protein	Fill Size	NDC Number
1 g	5 mL	44206-451-01
2 g	10 mL	44206-452-02
4 g	20 mL	44206-454-04

CPT is a registered trademark of the AMA, CPT^® 2010.

Where can my patients get more information about financial assistance?

Hizentra.com provides information about programs designed to help patients who can't afford Hizentra:

The CSL Behring Assurance^SM Program is designed to ensure that, if your patients rely on Hizentra to treat PIDD, they can continue to receive it even if they experience a lapse in third-party, private health insurance. Patients are eligible to redeem anywhere from a month's to a year's worth of product, depending on their needs and the length of their insurance gap
The CSL Reimbursement Answer Line is a general source of information about financial assistance programs, eligibility, and how to obtain forms for such programs. The CSL Reimbursement Answer Line (1-800-676-4266) is open Monday to Friday, 8:00 AM to 5:00 AM ET
The CSL Patient Assistance Program may help provide your patients with an SCIg if they are uninsured or underinsured or otherwise can't afford their medication

Important Safety Information

Immune Globulin Subcutaneous (Human), Hizentra^®, is indicated as replacement therapy for patients with primary humoral immunodeficiency (PI), age 2 and older. This includes but is not limited to the humoral immune defect in congenital agammaglobulinemia, common variable immunodeficiency, X-linked agammaglobulinemia, Wiskott-Aldrich syndrome, and severe combined immunodeficiencies.

Hizentra is contraindicated in patients with a history of anaphylactic or severe systemic reaction to human immune globulin preparations or components of Hizentra, such as polysorbate 80. Because it contains the stabilizer L-proline, Hizentra is contraindicated in patients with hyperprolinemia. Hizentra is also contraindicated in patients with immunoglobulin A deficiency who have antibodies against IgA and a history of hypersensitivity.

Hizentra should be administered subcutaneously only. Do not administer intravenously.

IgA-deficient patients with anti-IgA antibodies may be at greater risk of developing potentially severe hypersensitivity and anaphylactic reactions with administration of Hizentra. If hypersensitivity occurs or anaphylactic reactions are suspected, discontinue administration immediately and treat as medically appropriate.

Hizentra is derived from human plasma. The risk of transmission of infectious agents, including viruses and, theoretically, the Creutzfeldt-Jakob disease (CJD) agent, cannot be completely eliminated.

The most common drug-related adverse reactions (observed in 5% or more of study subjects receiving Hizentra) were local reactions (ie, swelling, redness, heat, pain, and itching at the injection site), headache, diarrhea, fatigue, back pain, nausea, extremity pain, cough, rash, pruritis, vomiting, upper abdominal pain, pain, and migraine.

Monitor patients for thrombotic events and aseptic meningitis (AMS), which have been reported with SCIg. Also look forreactions reported to occur with IVIg treatment that might also occur with Hizentra, including renal dysfunction/failure, hemolysis, and transfusion-related acute lung injury (TRALI).

Ig administration can transiently impair the efficacy of live attenuated virus vaccines, such as measles, mumps and rubella. It can also lead to misinterpretation of serologic testing.