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HCPCS Codes J9035 and C9257 for Avastin
|Article Number: 118 | Rating: Unrated | Last Updated: Wed, Nov 17, 2010 10:45 PM|
Which HCPCS code should we use for Avastin given for colon cancer. - J9035 or C9257? From what I have read, C9257 is used by ophthalmology for the drug in small doses and J9035 should be used for the larger doses given to cancer patients. However, we are reading conflicting info and want to make sure we are using the correct code.
For facility-based services, the Q2024 will be in effect until Dec. 31. After that date, hospitals should use C9257 for any ophthalmic use of Avastin. I found this same information on the website for the American Academy of Opthalmic Executives. Additionally, this information was distributed by Highmark Medicare:
When billing in the non-outpatient hospital setting: For bevacizumab, providers should use the HCPCS code J9035 (Injection, bevacizumab, 10 mg.), and bill for one unit (10 mg.). For ranibizumab, providers should use the HCPCS code J2778 (Injection, ranibizumab, 0.1 mg), and bill for the proper number of units. For Part B, the actual number of mg. utilized should be noted in Item 19 of the CMS Form 1500 or its electronic equivalent.
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