Portola Pharmaceuticals Announces the Establishment of a Permanent J-code for Andexxa by the Centers for Medicare & Medicaid Services, Effective July 1, 2020
SOUTH SAN FRANCISCO, Calif., April 7, 2020 /PRNewswire/ -- Portola Pharmaceuticals, Inc., Inc.® (NASDAQ: PTLA) today announced that the Centers for Medicare & Medicaid Services (CMS) established a new permanent J-code for Andexxa® [coagulation factor Xa (recombinant), inactivated-zhzo] facilitating reimbursement in the hospital outpatient setting. The code, J7169 (Injection, coagulation factor Xa (recombinant), inactivated-zhzo (Andexxa), 10 mg), published online in the Centers for Medicare & Medicaid Services (CMS) Healthcare Common Procedure Coding System (HCPCS) Application Summaries and Coding Decisions (page 41), will take effect on July 1, 2020 and it is expected to replace the previously issued temporary C-code.
"The J-code is specific to Andexxa and will serve as the permanent code for use of Andexxa in the hospital outpatient setting," said Sheldon Koenig, Portola's executive vice president and chief commercial officer. "Treating patients in emergency rooms before transporting them to another institution is a common practice, particularly in the setting of hemorrhagic stroke where 35% of patients are transferred for further treatment. This J-code brings us a step closer to ensuring greater patient access by providing hospitals with a clearer reimbursement pathway when administering Andexxa in this setting and will support our efforts to increase utilization in existing and new hospital accounts."
With the J-code taking effect in July, all hospital outpatient departments and freestanding emergency facilities in the United States will have one consistent HCPCS code to standardize the submission and payment of Andexxa insurance claims across Medicare, Medicare Advantage, Medicaid and commercial plans. The reimbursement rate under the J-code is expected to mirror the calculation under the current C-code.
ANDEXXA (coagulation factor Xa (recombinant), inactivated-zhzo) is a recombinant modified human factor Xa (FXa) protein indicated for patients treated with rivaroxaban or apixaban, when reversal of anticoagulation is needed due to life-threatening or uncontrolled bleeding.
Important Safety Information
The most frequently reported adverse reactions in clinical trials in healthy subjects with Andexxa were mild or moderate infusion-related reactions comprising symptoms such as flushing and feeling hot (very common), and cough, dysgeusia, and dyspnea (common). Amongst bleeding patients, commonly reported side effects were ischemic stroke and pyrexia, with uncommon reported side effects of cerebral infarction, cerebrovascular accident, transient ischemic attack, acute myocardial infarction, cardiac arrest, myocardial infarction, deep vein thrombosis, iliac artery occlusion, pulmonary embolism.
Please refer to full Prescribing Information for more information, including Boxed Warning, at www.Andexxa.com.
About Portola Pharmaceuticals, Inc.
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Company Codes: NASDAQ-NMS:PTLA