Wiki Avastin Inj code?

[slnrtcv]

I am new to Ophthalmology coding. We are having a problem with our Avastin Injection billing getting paid for. My boss was using the J3590 unclassified biologics but some of our carriers are now telling me it should be J9035. What are you using. Thanks

 

[OCD_coder]

Avastin (bevacizmab) is a chemotherapy drug and the J9035 (10mg=1 unit) is the correct HCPCS code you should be using for non-facility use. The facility would use C9257 HCPCS code.


http://www.genentech-access.com/avastin/hcp/see-how-we-can-help/our-services/reimbursement

 

[ShelleyM]

When we bill to Medicare or other government run programs we bill J3590, but when we bill to commercial payers we use J9035. It's the only way we have found they get paid without having to appeal.