KISUNLA J Code: J0175

Drug & Product Overview

HCPCS Descriptor Injection, donanemab-azbt, 2 mg

HCPCS Added Date July 2, 2024

Manufacturer Eli Lilly

Route of Administration Intravenous

Generic Status Single-Source; Branded

Dosage Type Single-Dose

Dosage Form Injection, Solution

About KISUNLA

Kisunla is a medication aligned to the HCPCS J Code: J0175 for billing, pricing, and reimbursement purposes in the United States. It is a Neurology drug administered via the intravenous route and manufactured by Eli Lilly.

According to CMS Drug Use Information: This medication is used to treat Alzheimer's disease. It is thought to work by decreasing a certain substance (amyloid beta) that builds up in the brain of a person with Alzheimer's disease. Donanemab belongs to a class of drugs known as monoclonal antibodies. This medication is not a cure for Alzheimer's disease. It may help slow down worsening of this disease and may delay disability.

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

Based on publicly available CMS files. The list of NDCs below is not exhaustive.

NDC Code	Drug	Manufacturer	Billing Units / Pkg	Package Size
00002-9401-01	Kisunla	Eli Lilly and Company	175	350 MG / 20 ML

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KISUNLA Pricing & Reimbursement

J0175 Private Payer Reimbursement

$4.16 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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Historical Graphing and Billing Calculator

per HCPCS unit

As of Q3 2026

KISUNLA CPT Administration Codes

CPT Code	Description
96365	Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour
96366	Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)

Not on the CMS JW / JZ list

This product is new and does not yet appear on the CMS list of HCPCS pertaining to single-dose containers. Wastage billing guide →

KISUNLA Medically Unlikely Edits (MUE)

The most billing units of J0175 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 2 mg.

Practitioner Office & Hospital Outpatient

700 units / day

= 1,400 mg per day

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 →

KISUNLA Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

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.

Alzheimer's disease

Frequently Asked Questions

Is there an available Kisunla billing and coding guide?

Billing and coding information for KISUNLA can be found through Eli Lilly. Visit Here →

Are there any available Kisunla patient assistance programs?

KISUNLA patient assistance information can be found through Eli Lilly. Visit Here →

Where can I find Kisunla prescribing information?

Kisunla prescribing information can be found at the link below: Visit Here →

Where can I find Kisunla side effect information?

Information regarding Kisunla's side effects can be found through the FDA.

Does billing KISUNLA require JZ/JW wastage modifiers?

CMS does not include KISUNLA (J0175) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J0175. For more information, visit the link below.

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