Injection of armlupeg (pegfilgrastim biosimilar), billed per 0.5 mg

This code represents a biosimilar formulation of pegfilgrastim (armlupeg) administered via injection, billed in 0.5 mg increments. Pegfilgrastim is a long-acting granulocyte colony-stimulating factor (G-CSF) used to stimulate neutrophil production and reduce the duration of severe neutropenia. Armlupeg is FDA-approved as a biosimilar to the reference product Neulasta (pegfilgrastim).

This code applies when armlupeg is administered to patients receiving myelosuppressive chemotherapy to decrease the incidence of febrile neutropenia. It is also indicated for hematopoietic subsyndrome of acute radiation syndrome. Supporting documentation should include the drug name and NDC, dose administered in milligrams, route of administration, and the clinical indication (e.g., chemotherapy regimen administered).

• Bill in units corresponding to the total dose administered divided by 0.5 mg (e.g., a 6 mg dose = 12 units); unit miscalculation is a frequent error with this code.
• Do not interchange with codes for other pegfilgrastim biosimilars (e.g., fulphila, nyvepria, ziextenzo) or the reference product Neulasta — payers require the specific biosimilar code matching the product dispensed, verified by NDC.
• Some payers require prior authorization and documentation that the biosimilar was dispensed per formulary or step-therapy requirements; confirm payer-specific biosimilar substitution policies before submission.