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Extavia Billing and Coding Guidelines

Effective 08/14/2009, the Food and Drug Administration (FDA) granted approval for Extavia, an interferon beta indicated for the treatment of relapsing forms of multiple sclerosis. According to the approved package insert, this drug should be self-administered by subcutaneous injection by the patient or caregiver and has only been approved for the following specific patient population:

  • Patients up to 65 years of age (Safety and efficacy have not been proven for an older population)
  • Patients who have experienced a first clinical episode and have MRI features consistent with Multiple Sclerosis

In the rare instance Extavia administration requires the direct supervision of a physician, providers should use HCPCS code J1830 – injection interferon beta-1b, 0.25 mg and submit the reason physician supervision was required with the redetermination.

 

last updated on 10/09/2009
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