Once a decision has been made to prescribe IMAAVY
Reimbursement, Billing, and Coding Support
A Field Reimbursement Manager (FRM) can help educate your office on reimbursement, billing, and coding for IMAAVY, so you can focus on your patients
A Field Reimbursement Manager (FRM) can help educate your office on reimbursement, billing, and coding for IMAAVY, so you can focus on your patients
Johnson & Johnson is committed to providing you with information to help guide you through the reimbursement process for IMAAVY.
For billing and coding, or reimbursement questions, or to request support from a Field Reimbursement Manager (FRM), call 844-4withMe
(844-494-8463844-494-8463), Monday–Friday, 8:00 AM–8:00 PM ET.
Coding and reimbursement support includes:
- In-office educational support from an FRM
- Information about dosing and formulation
- Coding for IMAAVY and drug administration
- Claim submission education
- Sample claim forms and a filing checklist
Product Information
National Drug Code (NDC)1
Payer requirements for NDC use and format can vary widely. Refer to sample claims forms beginning on page 6 of the Billing and Coding Guide for additional information.
FDA-Specified NDC
| 10-digit NDC (5-3-2 format) | 11-digit NDC (5-4-2 format) | Description |
|---|---|---|
| 57894-800-01 | 57894-0800-01 | One single-dose vial containing 300 mg/1.62mL (185 mg/mL) for intravenous injection |
| 57894-801-01 | 57894-0801-01 | One single-dose vial containing 1200 mg/6.5mL (185 mg/mL) for intravenous injection |
Coding for IMAAVY
ICD-10-CM Diagnosis Codes2
The table below lists ICD-10 diagnosis codes that you may need for patients treated with IMAAVY. These codes are not intended to be promotional or to suggest a use that is inconsistent with FDA-approved use. The list is not exhaustive and additional codes may apply.
ICD-10-CM Codes for Consideration
| G70.00 | Myasthenia gravis without (acute) exacerbation |
| G70.01 | Myasthenia gravis with (acute) exacerbation |
Drug HCPCS Code3
IMAAVY permanent J-code is effective January 1, 2026. Please refer to the information below to support appropriate claims processing for IMAAVY. Always check specific payer requirements when submitting claims for IMAAVY.
J9256
Injection, nipocalimab-aahu, 3 mg3
Current Procedural Terminology (CPT®) Codes for Drug Administration4
Payer policies for codes that describe drug administration services may vary; contact your payer for their code requirements.
| CPT® Code | Description |
|---|---|
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour |
| 96413 | Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug |
NOTE: An infusion of 15 minutes or less is an intravenous push.
HCPCS Modifiers5,6
| Modifier | Code Description |
|---|---|
| JW | Drug amount discarded/not administered to any patient |
| JZ | No discarded drug amounts |
| TB | Drug or biological acquired with 340B pricing program discount, reported for informational purposes |
Place of Service Codes7
| Code | Place of Service |
|---|---|
| 11 | Office |
| 19 | Off campus–outpatient hospital |
| 22 | On campus–outpatient hospital |
Revenue Codes8
| Code | Descriptor |
|---|---|
| 0260 | IV (Intravenous) therapy, general |
| 0510 | Clinic, general |
| 0636 | Pharmacy, drugs requiring detailed coding |
NOTE: Many payers require revenue codes for hospital outpatient department claims.
These codes are not intended to promote, encourage, or suggest use of a drug that is inconsistent with FDA-approved use. This list is not exhaustive, additional codes may apply, and listed codes may require a higher level of specificity when reporting for individual patients. Please consult your ICD-10-CM codebook for more information.
This information is not a promise of coverage or payment. It is not intended to give reimbursement advice or increase reimbursement by any payer. Legal requirements and plan information can be updated frequently. Contact the plan for more information about current coverage, reimbursement policies, restrictions, or requirements that may apply.
For more information on ICD-10, visit the CMS website.
FDA, Food and Drug Administration; HCPCS, Healthcare Common Procedure Coding System; ICD-10-CM, International Classification of Disease, Tenth Revision, Clinical Modification.
References: 1. IMAAVY [Prescribing Information]. Horsham, PA: Janssen Biotech, Inc. 2. Centers for Medicare & Medicaid Services. 2026 ICD-10-CM. August 7, 2025. Accessed October 5, 2026. https://www.cms.gov/medicare/coding-billing/icd-10-codes#CodeFiles 3. Centers for Medicare & Medicaid Services. Centers for Medicare & Medicaid Services (CMS) Healthcare Common Procedure Coding System (HCPCS) Application Summaries and Coding Determinations. Third Quarter, 2025 HCPCS Coding Cycle. Published October 21, 2025. Accessed October 5, 2026. https://www.cms.gov/files/document/2025-hcpcs-application-summary-quarter-3-2025-drugs-biologicals.pdf 4. American Medical Association. Current Procedural Terminology: CPT® 2025: Professional Edition. Chicago, IL: American Medical Association; 2024 5. Centers for Medicare & Medicaid Services. Medicare Program Discarded Drugs and Biologicals – JW Modifier and JZ Modifier Policy Frequently Asked Questions. Accessed October 5, 2026. https://www.cms.gov/medicare/medicare-fee-for-service-payment/hospitaloutpatientpps/downloads/jw-modifier-faqs.pdf 6. Centers for Medicare & Medicaid Services. Medicare Part B Inflation Rebate Guidance: Use of the 340B Modifier. November 2024. Accessed October 5, 2026. https://www.cms.gov/files/document/mln4800856-medicare-part-b-inflation-rebate-guidance-use-340b-modifier.pdf 7. Centers for Medicare & Medicaid Services. Medicare Claims Processing Manual. Chapter 26: Completing and Processing the Form CMS-1500 Data Set. Revised August 9, 2024. 8. Noridian Healthcare Solutions. Revenue Codes. Last updated June 17, 2025. Accessed October 5, 2026. https://med.noridianmedicare.com/web/jea/topics/claim-submission/revenue-codes
Your Johnson & Johnson representative is your liaison who can help connect your office with the team members, information, and resources from IMAAVY withMe.
Request a representativeFor more information, call 844-4withMe (844-494-8463844-494-8463), Monday–Friday, 8:00 AM–8:00 PM ET.