Soliris (eculizumab) is an ultra-orphan drug billed under J1300. Given its extreme cost, a single billing error will result in a massive financial delay for your practice.
Billing Units for Soliris (J1300)
The HCPCS definition for J1300 is "Injection, eculizumab, 10 mg".
For a standard 900 mg maintenance dose, divide by 10. You must bill exactly 90 units.
| Drug | Code | Administered Dosage | Billing Units |
|---|---|---|---|
| Soliris | J1300 | 900 mg | 90 |
Medical Necessity & ICD-10 Codes
Medicare rigorously restricts Soliris to specific rare conditions:
- D59.5 - Paroxysmal nocturnal hemoglobinuria (PNH)
- D59.3 - Hemolytic-uremic syndrome (aHUS)
Administration Coding
Soliris is administered intravenously. Bill standard therapeutic infusion codes (96365 for the initial hour).