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DrugXgeva (denosumab) [Amgen]

October 2013

Therapeutic area - Bone resorption inhibitors

Xgeva should be administered by a healthcare professional and billed using professional claim code J0897 (buy and bill).

Approval criteria

  • Patient has bone metastases from solid tumors AND 
  • Patient has previously been treated with zoledronic acid (Zometa) to reduce and delay bone complications due to bone metastases from solid tumors AND
  • Patient has a documented severe intolerance to Zometa OR
  • Experienced a skeletal related event (SRE) while on therapy (i.e, pathologic fractures, radiation therapy to bone, surgery to bone, and spinal cord compression) AND
  • Prescriber sends documentation of time on therapy with zoledronic acid and type of SRE or severe intolerance description

Exclusion criteria

Patient has multiple myeloma.


MHCP Provider Call Center 651-431-2700 or 800-366-5411

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