Practice Support

HELPING YOU INTEGRATE FIRMAGON® (degarelix for injection) INTO YOUR PRACTICE

We offer extensive services and information to help reduce disruption to operations so you can focus on patient care. From reimbursement codes to up-to-date ordering options, we help your practice at a level that suits your needs.

Request a Rep Visit

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One of our helpful reps would be happy to come to your office, answer any questions you may have about FIRMAGON, and provide useful resources for your practice.

Two Ways to Order

There are 2 potential ways to acquire FIRMAGON for your patients: either through a specialty pharmacy or buy-and-bill. In many cases, you can determine the best option for your practice.

Two ways to order Firmagon®
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SUPPORT THROUGHOUT THE PROCESS

Enroll your practice in FIRMAGON Support Services

  • Speak with trained reimbursement specialists by phone or Live Chat 24/7
  • Quick-launch access to most-used links and forms
  • Easy-to-find, up-to-date Medicare reimbursement rate
  • Comprehensive list of all cases with current status and associated documents

Already enrolled?
Visit firmagononline.com.

To enroll by telephone, call 877-971-3778.

FIRMAGON REIMBURSEMENT CODES & MONTHLY BILLING

FIRMAGON Is Billed By The Milligram (mg): Starting Dose = 240 mg; Each Subsequent Dose = 80 mg.

HCPCS J9155 1 mg, injection degarelix
CPT 96402* Chemotherapy administration, subcutaneous or intramuscular: hormonal antineoplastic
NDC 55566-8403-1
55566-8303-1
FIRMAGON 240 mg dose (120 mg x 2)
FIRMAGON 80 mg dose (80 mg x 1)
ICD-10-CM Malignant neoplasm of prostate (C61)
HCPCS
/
J9155
1 mg, injection degarelix
CPT
/
96402
Chemotherapy administration, subcutaneous or intramuscular: hormonal antineoplastic
NDC
/
55566-8403-1
55566-8303-1

FIRMAGON 240 mg dose (120mg x 2)
FIRMAGON 80 mg dose (80mg x 1)
ICD-10-CM
Malignant neoplasm of prostate (C61)

This information is provided for reference only. The healthcare provider must determine the proper coding for the applicable diagnosis and treatment provided, in his/her medical discretion.

Coverage and payment policies for the same insurer, such as Medicare, can vary from one region to another and may change from time to time because of ongoing changes in government and insurance industry rules and regulations. Ferring does not guarantee coverage or payment of its products.

For more information about ICD-10, visit www.cms.gov/Medicare/Coding/icd10

*The practitioner must determinate the proper coding for the treatment provided.

Use the product-specific HCPCS code J9155 for both doses of FIRMAGON.

Firmagon® is billed by the milligram. Starting dose: 240mg; Each subsequent dose: 80mg

*Starting dose can be billed as 2 separate injection procedures in the first month.

Refer to Evaluation and Management coding (E/M) requirements to apply the correct code.

CPT is a registered trademark of the American Medical Association (AMA)

99214: A level-4 established office visit involves 2 out of 3 of the following: a detailed history, detailed examination, and medical decision-making of moderate complexity or 25 minutes of face-to-face with the patient.

99213: A level-3 established office visit involves 2 out of 3 of the following: expanded problem-focused history, expanded problem-focused examination, and medical decision-making of low complexity or 15 minutes of face-to-face with the patient.

99212: A level-2 established office visit involves 2 out of 3 of the following: problem-focused history, problem-focused examination, and straightforward medical decision-making or 10 minutes of face-to-face with the patient.

ORDERING OPTIONS

Physician Ordering Options
Besse Medical* 1-888-252-5585
Cardinal Health Specialty Pharmaceutical Distribution* 1-866-300-3838
CuraScript SD 1-877-599-7748
Ferring Pharmaceuticals Inc 1-888-337-7464
Henry Schein Medical 1-800-772-4346
McKesson Specialty Care Solutions 1-888-625-7732
Oncology Supply 1-800-633-7555
Physician Ordering Options
Besse Medical*
1-888-252-5585
Cardinal Health Specialty Pharmaceutical Distribution*
1-866-300-3838
CuraScript SD
1-877-599-7748
Ferring Pharmaceuticals Inc
1-888-337-7464
Henry Schein Medical
1-800-772-4346
McKesson Specialty Care Solutions
1-888-625-7732
Oncology Supply
1-800-633-7555

120 Day Payment Terms.

Payment by MasterCard or Visa only.

WHOLESALE ORDERING OPTIONS

Prefilled kit item number

240 mg

80 mg

AmerisourceBergen Drug
Company — SAP

Prefilled kit item number

240 mg

80 mg

10118920

10118986

Bellco Drug Corp

Prefilled kit item number

240 mg

80 mg

497686

497694

Burlington Drug Company

Prefilled kit item number

240 mg

80 mg

874370

874404

Cardinal Health, Inc

Prefilled kit item number

240 mg

80 mg

4894218

4894200

Dik Drug Co

Prefilled kit item number

240 mg

80 mg

4894218

4894200

H.D. Smith Wholesale Drug

Prefilled kit item number

240 mg

80 mg

3621570

3621562

McKesson Drug Co

Prefilled kit item number

240 mg

80 mg

2024743

2024750

Morris & Dickson Co, LLC

Prefilled kit item number

240 mg

80 mg

396143

395947

Wholesale Ordering Options Prefilled Kit Item Number
240 mg 80 mg
AmerisourceBergen/Cencora 10118920 10118986
Burlington Drug Company 902320 748954
Cardinal Health, Inc 4894218 4894200
McKesson Drug Co 2024743 2024750
Morris & Dickson Co, LLC 651281 486837
Smith Drug Company 902320 748954