Oncology & Hematology Coding Alert

Reader Questions:

Avastin Claims Go Great With J9999

Question: Our office recently began administering Avastin through intravenous chemotherapy infusions, but we are having trouble reporting the drug supply. How can we successfully code for the supply of Avastin?

Massachusetts Subscriber Answer: Recently approved by the Food and Drug Administration, Avastin is used by oncologists to treat patients with first-line colon or rectal cancer. When your oncologist conducts an IV chemo infusion with Avastin, you can get reimbursed for the drug supply.
 
On the claim, you should report J9999 (NOC [not otherwise classified], antineoplastic drug) for the Avastin (aka Bevacizumab) supply.
 
Don't forget. Attaching the appropriate ICD-9 code(s) to the infusion code(s) will strengthen your claim. In this cases, you should select a diagnosis code from either the 153.0-153.9 series (Malignant neoplasm of colon) or the 154.0-154.8 series (Malignant neoplasm of rectum, rectosigmoid junction, and anus).
 
To code the chemotherapy administration of Avastin, the oncologist must deliver the drug via intravenous infusion. Also remember to include the name of the drug and the national drug code (NDC) in the free-form field of an electronic claim, or in Box 19 of a paper claim.
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