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Resources for

Patient Access & support

YOUR SOURCE FOR SUPPORT

TO GET PATIENTS TIMELY ACCESS TO SKYRIZI

Enrollment.

SKYRIZI COMPLETE ENROLLMENT

Ready to enroll your patient in Skyrizi Complete and start the process?

 

Computer.

BILLING AND CODING

Clear guidance on billing and coding for SKYRIZI, including new NDC codes.

 

Savings Card.

ACCESS AND REIMBURSEMENT

Forms and instructions to help patients with access and coverage.

 

Pharmacy.

SPECIALTY PHARMACIES

 

Contact details for specialty pharmacies.

 

SPECIALTY PHARMACIES

Contact details for specialty pharmacies

 

This information is for informational purposes only and is not intended to provide reimbursement or legal advice. The information presented here does not guarantee payment or coverage.

 

Enrollment.

SKYRIZI COMPLETE ENROLLMENT

SKYRIZI COMPLETE ENROLLMENT AND PRESCRIPTION FORM

  • Download and fill out the Skyrizi Complete Enrollment and Prescription Form with your patient
  • After submitting the form via fax, your patient will receive a call from a Nurse Ambassador*
  • You may also complete the Pharmacy Prescription Form and fax it to your patient's specialty pharmacy

GUIDE TO STARTING SKYRIZI

Reference this guide for a comprehensive list of steps to take and communication to expect when starting a patient on SKYRIZI.

PRIOR AUTHORIZATION INSTRUCTIONS

Follow this helpful checklist to request coverage for SKYRIZI.

*Nurse Ambassadors are provided by AbbVie and do not provide medical advice or work under the direction of the prescribing health care professional (HCP). They are trained to direct patients to speak with their HCP about any treatment-related questions, including further referrals.

Computer.

BILLING AND CODING

GUIDE TO BILLING AND CODING

Your guide to relevant codes (including commercial and Medicare) as well as helpful tips for completing forms.

NDC CODES1

SKYRIZI Pen 150 mg/mL
0074-2100-01
Carton of 1
SKYRIZI Prefilled Syringe 150 mg/mL
0074-1050-01
Carton of 1

ICD-10-CM DIAGNOSIS CODE2†‡

Plaque Psoriasis

ICD-10-CM code Description
L40.0 Psoriasis vulgaris
L40.8 Flexural psoriasis
L40.9 Psoriasis, unspecified

Psoriatic Arthritis

ICD-10-CM code Description
L40.5 Arthropathic psoriasis
L40.50 Arthropathic psoriasis, unspecified
L40.51 Distal interphalangeal psoriatic arthropathy
L40.52 Psoriatic arthritis mutilans
L40.59 Other psoriatic arthropathy



HEALTHCARE COMMON PROCEDURE CODING SYSTEM (HCPCS) CODES3

 

HCPCS code Description Payer type
J3590 Unclassified biologics Commercial, Medicare
C9399 Unclassified drugs or biologics Medicare

ICD-10-CM=International Classification of Diseases, Tenth Revision, Clinical Modification.

The codes shown above are only general suggestions and are not intended to encourage or suggest a use of any drug that is inconsistent with FDA-approved use.

This information is presented for informational purposes only and is not intended to provide reimbursement or legal advice. Providers are encouraged to contact third-party payers for specific information about their coverage policies.

Savings Card.

ACCESS AND REIMBURSEMENT FORMS

Along with support from Skyrizi Complete, you can use the forms here to help patients with access and coverage for SKYRIZI.

APPEALS LETTER SAMPLE

Appeal a denied claim for SKYRIZI.

TEMPLATE

FORMULARY EXCEPTION LETTER

Request a formulary exception to allow coverage for SKYRIZI.

TEMPLATE

HIPAA AUTHORIZATION

Allow patients to authorize the release of health information related to their treatment with SKYRIZI.

TEMPLATE

LETTER OF MEDICAL NECESSITY

Establish the medical necessity of SKYRIZI.

TEMPLATE

TIERED EXCEPTION LETTER

Request lower cost sharing for SKYRIZI as a preferred medication.

TEMPLATE

Woman receiving support.

For support in person or over the phone, call your Access Specialist at 1-877-COMPLETE (1-877-266-7538)

Pharmacy.

SPECIALTY PHARMACIES

CONTACT DETAILS FOR SPECIALTY PHARMACIES

A complete list of specialty pharmacies that provide product-specific support for SKYRIZI.

Use these guides & best practices to help
get patients timely access to SKYRIZI

SKYRIZI ONBOARDING

ADDITIONAL RESOURCES

INJECTION SUPPORT VIDEOS

Injection Training Quick Tips

The resources on this page are provided for informational purposes only and are not intended as reimbursement or legal advice. The information presented here does not guarantee payment or coverage.

Computer screen Icon

SKYRIZI ONBOARDING

SKYRIZI COMPLETE ENROLLMENT AND PRESCRIPTION FORM

Download and fill out the Skyrizi Complete Enrollment and Prescription Form with your patient. After submitting the form via fax, your patient will receive a call from a Nurse Ambassador.* You may also complete the Pharmacy Prescription Form and fax it to your patient's specialty pharmacy.

*Nurse Ambassadors are provided by AbbVie and do not provide medical advice or work under the direction of the prescribing health care professional (HCP). They are trained to direct patients to speak with their HCP about any treatment-related questions, including further referrals.

ADDITIONAL RESOURCES

BENEFITS VERIFICATION CHART

Help patients confirm their insurance coverage and out-of-pocket costs.

INSURANCE COMPARISON

Simple steps to help patients choose their insurance coverage when it's time to pick a plan.

PATIENT BROCHURE

Prepare patients for treatment with SKYRIZI with information on plaque psoriasis, SKYRIZI efficacy, and more.

SKYRIZI COMPLETE BROCHURE

Information about the resources available from Skyrizi Complete, including Nurse Ambassadors, injection support, and possible ways to save.*

AAD RECOMMENDATIONS FOR TELEMEDICINE PREPAREDNESS

Tips for meeting with a dermatologist via phone or video chat from the American Academy of Dermatology Association.

PASI SCORE CALCULATOR

Allows patients to enter the locations and severity of their symptoms and produce their current PASI score.

*Nurse Ambassadors are provided by AbbVie and do not provide medical advice or work under the direction of the prescribing health care professional (HCP). They are trained to direct patients to speak with their HCP about any treatment-related questions, including further referrals.

INJECTION SUPPORT VIDEOS

A patient-friendly video with instructions on the full process of injecting SKYRIZI.

150 mg/mL SKYRIZI PEN

150 mg/mL PREFILLED SYRINGE

INJECTION TRAINING QUICK TIPS

A quick-tip guide for patients on how to inject, whether they have injected before or are new to it. 

150 mg/mL SKYRIZI PEN

150 mg/mL PREFILLED SYRINGE

looking for more resources?Offer enrollment to patients and submit forms
electronically with CompletePro.com

By registering through CompletePro.com, you can choose the
capabilities that are most relevant to you and your patients’ needs, such as:

Instant benefits verification:

  • Patient out-of-pocket costs
  • Any prior authorization requirements
  • Pharmacy options available to the patient
  • Patient eligibility for any drug discount from the pharmaceutical company

Online prescribing efficiencies:

  • Complete a prior authorization and send it directly to the insurer
  • Send a prescription directly to the patient's chosen pharmacy
  • Send Skyrizi Complete Savings Card to your patient's preferred specialty pharmacy (with or without a prescription)
  • Be notified via text, email, or website in advance of patient's prior authorization expiration
  • Easily access each patient's prescription fill status

To get started with Complete Pro, speak with your Sales Representative or call Technical Support at 1-877-COMPLETE (1-877-266-7538)

Stay up to date on the latest SKYRIZI news and information


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ENROLL PATIENTS IN SKYRIZI COMPLETE

Resources for your patients

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