Each 1 mg of depemokimab-ulaa administered by subcutaneous injection

Depemokimab-ulaa (Nucala) is a long-acting anti-IL-5 monoclonal antibody administered as a subcutaneous injection for eosinophil-driven conditions. This code is billed per 1 mg of drug administered, requiring units to reflect the total milligrams dispensed. The drug's extended half-life allows for less frequent dosing compared to earlier IL-5 antagonists.

This code applies when depemokimab-ulaa is administered in a physician office, outpatient clinic, or other Part B-covered setting for FDA-approved indications, including severe eosinophilic asthma, eosinophilic granulomatosis with polyangiitis (EGPA), or hypereosinophilic syndrome (HES). Documentation should confirm the diagnosis, eosinophil count or clinical criteria supporting medical necessity, and the exact dose administered. Prior authorization is typically required; ensure the PA approval and supporting lab values are on file before billing.

• Unit reporting is critical: The approved dose is 100 mg subcutaneously every 6 months; bill 100 units per administration. Undercoding units is a common error that results in significant reimbursement loss.
• Do not confuse with mepolizumab (Nucala) codes — depemokimab-ulaa is a distinct, newer long-acting molecule with its own HCPCS code; using a mepolizumab code for this drug constitutes a coding error regardless of brand name similarity.
• Pair with the appropriate administration code (e.g., subcutaneous injection administration) and verify payer-specific policies, as some payers may require buy-and-bill versus specialty pharmacy dispensing, which affects whether the drug code is billable in the office setting.