Wiki Avastin & PDR

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coderknitter

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I work for a retina specialist and I am trying to find out if Medicare pays for Avastin
(J3590) with PDR (362.02) as the primary diagnosis and no DME (362.07) present. I find the LCD L25820 and the related article A46095 very confusing. Thank you.
 
Try Article A9034, found on Novitas Solutions Site

This Article (Article A49034) gives info regarding coverage and how to code it. Hope it helps.

Coverage is available for age-related macular degeneration (AMD), ischemic retinal vein occlusions, and decreasing the vascularity of proliferative diabetic retinopathy prior to vitreous surgery.
 
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