Ohtuvayre® (ensifentrine) - Correct Coding and Coverage

Ohtuvayre® (ensifentrine) is a new inhalation solution approved by the U.S. Food and Drug Administration on June 26, 2024 and is indicated for the maintenance treatment of chronic obstructive pulmonary disease (COPD) in adult patients. The recommended dosing is 3 mg (one ampule) twice daily administered by oral inhalation using a standard jet nebulizer with a mouthpiece. Ohtuvayre® is supplied in a carton of 60 unit-dose ampules (NDC 83034-003-60). On the claim, suppliers should indicate the units of service dispensed as number of milligrams (mg).

Claims for Ohtuvayre® (ensifentrine) for dates of service on or after June 26, 2024 must be submitted using the HCPCS code J7699 (NOC DRUGS, INHALATION SOLUTION ADMINISTERED THROUGH DME). Suppliers are reminded that when submitting claims for items coded J7699, the supplier must include the following information on each claim:

• Name of Drug
• Manufacturer name
• Dosage Strength

This information must be entered in the narrative field of an electronic claim (NTE 2300 or NTE 2400 of an electronic claim) or Item 19 of a paper claim.

For questions about correct coding, contact the PDAC HCPCS Helpline at (877) 735-1326 during the hours of 9:30 a.m. to 5:00 p.m. ET, Monday through Friday. You may also visit the PDAC website to chat with a representative or select the Contact Us button at the top of the PDAC website for email, FAX, or postal mail information.