What drug classification is STELARA?
What drug classification is STELARA?
Ustekinumab is a drug that reduces the signs and symptoms of active psoriatic arthritis, such as psoriasis and joint swelling. It is also approved for the treatment of plaque psoriasis and moderate to severe, active Crohn’s disease. Ustekinumab is commonly known as Stelara®. It is a type of drug called a biologic.
How do you bill a STELARA injection?
Effective January 1, 2018, the product-specific HCPCS code for STELARA® is J3358, ustekinumab, for intravenous injection, 1 mg. It is important to note that this code represents 1 mg or 1/130th of a vial. You should be sure to bill 130 units of J3358 on the claim form for each 130-mg vial of STELARA® that was used.
What is the drug STELARA used for?
STELARA® is a prescription medicine used to treat: adults and children 6 years and older with moderate to severe psoriasis who may benefit from taking injections or pills (systemic therapy) or phototherapy (treatment using ultraviolet light alone or with pills).
Is STELARA a Part D drug?
Most patients with Medicare pay between $0 and $32 per month for STELARA®. This number represents Medicare Part D, including those with LIS.
Is STELARA an immunosuppressant drug?
STELARA® is an immunosuppressant and may increase the risk of malignancy. Malignancies were reported among patients who received STELARA® in clinical studies. The safety of STELARA® has not been evaluated in patients who have a history of malignancy or who have a known malignancy.
Is STELARA a high risk medication?
STELARA® is a prescription medicine that affects your immune system. It can increase your chance of having serious side effects including serious infections, cancer, serious allergic reactions, lung inflammation, and a rare condition called posterior reversible encephalopathy syndrome.
What is the CPT code for STELARA Injection?
Six of the 8 Medicare Administrative Contractors (MACs) have published policies specifically requiring the use of CPT 96365 for STELARA® (IV) administration.
What is the ICD 10 code for STELARA?
STELARA® (ustekinumab) is indicated for the treatment of adult patients with active psoriatic arthritis….ULCERATIVE COLITIS.
| ICD-10 Indication | ICD-10 Code |
|---|---|
| Ulcerative colitis, unspecified | K51.9 |
| … without complications | K51.90 |
| … with complications | K51.91 |
What are the side effects of the drug STELARA?
Common side effects of STELARA® include: nasal congestion, sore throat, and runny nose, upper respiratory infections, fever, headache, tiredness, itching, nausea and vomiting, redness at the injection site, vaginal yeast infections, urinary tract infections, sinus infection, bronchitis, diarrhea, stomach pain, and …
Is STELARA a steroid?
STELARA® is not a steroid. STELARA® targets an underlying cause of plaque psoriasis and psoriatic arthritis—an overactive immune system. It blocks the action of IL-12 and IL-23, two proteins that may play a role in plaque psoriasis and active psoriatic arthritis.
Is STELARA a Medicare Part B drug?
Since 2016, total Medicare Part B payments to physicians for Stelara-an expensive drug used to treat certain autoimmune diseases that is often self-injected by patients in their home-have increased substantially.
Is STELARA infusion covered by Medicare Part B?
Medicare will no longer cover STELARA SQ injections under the medical benefit (Part B) and instead will cover STELARA SQ under the prescription benefit (Part D).
