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South Carolina Part B Carrier
Avastin Coverage for Intraocular Use

Effective immediately, the Centers for Medicare & Medicaid Services (CMS) no longer recognizes Healthcare Common Procedure Coding System (HCPCS) Code Q2024 Bevacizumab (Avastin®) for payment of non-outpatient hospital claims. Practitioners shall return to their previous reporting practice for small intraocular doses of Bevacizumab (Avastin®) furnished prior to October 1, 2009. HCPCS Code Q2024 will be deleted as of January 1, 2010, and, therefore, it will be removed from the Average Sales Price (ASP) pricing file effective with the January 2010 Release.

To bill intraocular Avastin services, submit the following codes:

  • CPT code 67028-intravitreal injection of a pharmacologic agent
  • HCPCS code J3590-unclassified biologics
  • Enter the following information in the Loop 2300, or 2400, NTE, 02 (for paper claims, submit 'NDC' information on an attachment to the claim form):
    • Intraocular Avastin
    • Dose given
NOTE: According to the medical literature, the recommended dose for intraocular Avastin is 1.25mg per affected eye.

 

last updated on 11/18/2009
CMS