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Avastin 1.25 mg given for Macular Degeneration

Sandy Posted Tue 02nd of November, 2010 15:23:13 PM

What is the appropriate HCPCS Code for the billing of Avastin (BEVACIZUMAB)1.25 mg given intravitreal. Q2024 has been deleted. J9035 is 10 mg, too large of dose - no modifier available to reduce cost of reimbursement.
Thank You,

SuperCoder Answered Wed 03rd of November, 2010 19:22:14 PM

Bill C9257 with 5 units.

Sandy Posted Thu 04th of November, 2010 17:00:48 PM

Thank you for your response, however I failed to clarify this service was rendered in a physician's office and not in an Outpatient (OP) setting. Generally, "C" Codes are specific to OP setting. Now armed with this new information, how would you code for 1.25mg Avastin?

Donna Answered Wed 09th of March, 2011 21:15:49 PM

We were informed by our highmark mc carrier to bill j9035 1 unit- for up to 10mg of avastin

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