Injection of belantamab mafodotin-blmf, billed per 0.1 mg administered

Belantamab mafodotin-blmf (Blenrep) is an antibody-drug conjugate (ADC) targeting BCMA (B-cell maturation antigen), indicated for the treatment of relapsed or refractory multiple myeloma. The drug is dosed in mg/kg and administered via intravenous infusion, with this code representing a per-0.1 mg billing unit. Note: FDA approval was voluntarily withdrawn in November 2022 pending confirmatory trial results; payer coverage policies vary and should be verified prior to billing.

This code applies when belantamab mafodotin-blmf is administered to adult patients with relapsed or refractory multiple myeloma who have received at least four prior therapies, including an anti-CD38 monoclonal antibody, a proteasome inhibitor, and an immunomodulatory agent. Documentation should include the patient's diagnosis (typically C90.00–C90.02), prior treatment history confirming eligibility, the ordered dose in mg/kg, the patient's weight used for dose calculation, and the total mg administered. Units billed are calculated by dividing the total mg administered by 0.1 and rounding per payer policy.

• Unit calculation is critical: Divide total mg administered by 0.1 to determine billable units; document actual dose prepared and administered, including any waste, as some payers require single-dose vial waste reporting.
• Verify active coverage before billing: Given the voluntary FDA withdrawal, prior authorization requirements are heightened; some payers may require medical necessity documentation referencing clinical trial access, compassionate use, or updated labeling if reapproval occurs.
• Report the appropriate administration code separately: Bill the applicable chemotherapy administration code (e.g., 96413 for initial infusion) alongside this drug code; do not bundle the drug into the administration charge.