ARCALYST J Code: J2793
Injection, rilonacept, 1 mg
Drug & Product Overview
About ARCALYST
Arcalyst is a medication aligned to the HCPCS J Code: J2793 for billing, pricing, and reimbursement purposes in the United States. This Immunology medication is administered via the subcutaneous route and manufactured by Kiniksa Pharmaceuticals (uk).
Manufacturers, reach out to us to add more information.
NDC Code Information
1 NDC package is crosswalked to J2793. Package detail is available to logged-in subscribers.
| NDC Code | Drug | Manufacturer | Billing Units / Pkg | Package Size |
|---|---|---|---|---|
| •••••-••••-•• Log in to view | ARCALYST | •••••••••••• Log in to view | •••• Log in to view | ••• •• / • •• Log in to view |
ARCALYST Pricing & Reimbursement
National median reimbursement across major commercial payers.
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ARCALYST CPT Administration Codes
The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.
| CPT Code | Description |
|---|---|
| 96372 | Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intramuscular |
CMS does not include Arcalyst (J2793) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J2793. Wastage billing guide →
ARCALYST Medically Unlikely Edits (MUE)
The most billing units of J2793 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.
MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →
ARCALYST Clinical Information
Indications and drug classification.
This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.
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Frequently Asked Questions
Is there an available Arcalyst billing and coding guide?
Are there any available Arcalyst patient assistance programs?
Where can I find Arcalyst prescribing information?
Where can I find Arcalyst side effect information?
Does billing ARCALYST require JZ/JW wastage modifiers?
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