Comprehensive coverage for your YUPELRI patients
*This is not a guarantee of coverage. Site of care will determine coverage. Check with your patient’s insurance provider for coverage rules and restrictions. In certain limited instances YUPELRI may be covered through a patient’s Medicare Part D pharmacy benefit.
Get Your Medicare Part B Patients Started Today
|Be Sure to Use the Appropriate Codes§|
|ICD-10 COPD Code||Permanent J-CODE||YUPELRI NDC No.|
Please find general information on Medicare Part B documentation requirements and coding below
This is general information on how to prepare claims for patients who have been prescribed YUPELRI. Each office remains responsible for properly submitting all claims for medically appropriate patients. Please refer to CMS regulations and guidance and applicable MAC documentation requirements.
Be sure to use the appropriate codes ‡
ICD-10 COPD Code
New patients who don’t already own a nebulizer will need 2 separate prescriptions and a detailed written order for Medicare Part B‡
When prescribing YUPELRI for patients new to nebulized therapy, include the following:
1A prescription for YUPELRI
- Dosing instructions
- "Via standard jet nebulizer"
- Quantity to be dispensed
- Number of refills
- ICD-10 code
2A prescription for the standard jet nebulizer§
3Detailed written order20
Medicare requires a physician to document that a face-to-face evaluation with the patient, detailing the treatment and/or evaluation of a condition that supports the need for the nebulizer, occurred within the 6 months prior to the written order for a nebulizer.
‡Other codes may apply.
§DME suppliers may require additional documentation.