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 PROVIDER RESOURCES |
Introduction
The content on this page is a resource for physicians, practice managers, and their staff. To manage a medical practice, you need certain tools, like coding and billing materials, details about payers, and prescribing information. Whether you have an established practice or you are just starting, these resources will help you and your staff.
2010 STELARA™ (ustekinumab) Billing and Coding Summary. A summary of the most relevant 2010 billing codes for submitting physician office-based and hospital outpatient claims to Medicare and commercial private payers for therapy with STELARA. This reference includes diagnosis codes and coding to describe STELARA and associated services and a sample of the CMS-1500 and UB-04 Medicare and Commercial Payer Claim forms. The former is for providers and latter is for hospital outpatient departments. These sample claim forms include important reminders about how to submit a claim that meets payer requirements. Click here for the Billing and Coding Summary. Click here for the Sample CMS-1500 and UB-04 Forms.
Payer Policy Summary Sheet. This form helps your practice keep track of key payer policies to ensure you are following their requirements. Click here for the form.
Prescription Information, Nursing Order and STELARA™ Support Enrollment Form (PEF) (editable). This form combines the benefit investigation request, patient authorization, STELARA™ Support enrollment and Prescription Information into one form. Click here for the form.
Sample Format Letter of Medical Necessity. Sample letter that you can submit with either the initial claim to support the medical necessity of treatment with STELARA for your patient or submit it to support the medical necessity of treatment with STELARA when requesting reconsideration of a denied claim. Click here for the sample letter.
Specialty Distributors for STELARA™. STELARA is available from this list of specialty distributors for those prescribers who want to directly purchase STELARA. Click here for the form.
Specialty Pharmacy Delivery Checklist (editable). Provides practices with a form to help them keep track of important information for each Specialty Pharmacy they may use to obtain STELARA. Click here for the form.
Suggested SPP Inventory Summary. This document provides a way for you to track and control inventory supplied by specialty pharmacy providers (SPPs). Click here for the form.
Tracking Log for STELARA™. This form helps you track and manage your inventory stock for STELARA™ in a consistent and efficient manner. Click here for the form.
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