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1199SEIU- Avastin injection with age-related macular degenaration-updated for 2019

As of 4/9/2019- 1199 has published the updated information, regarding the drug bevacizumab (Avastin)

The following is the new information:

If the patient is seen in the hospital or a facility setting then the proper code is C9257.

If the patient is receiving the injection in the private office, then the proper HCPCS code is J7999.

The HCPCS codes J3490 and J3590 will be denied as invalid codes.

1199SEIU also increased its reimbursement for the injection: “The standard dosage reimbursement is now 0.25mg (6)×5 units, equaling $30 per standard dosage”. However, manufacturer does not package or prepare it in that way. According to 1199, there are single-dose (1.25 mg/eye) compound syringes that can be made in the pharmacy, to minimize the conramination risk of the injection drug. Pharmacy needs to be a qualified 1199 pharmacy.

Author:

My name is Kate Patskovska, CPB. I am an Independent Medical Biller CPB (AAPC) and an owner of KR2 Medical Billing. KR2 Medical Billing is a full service Consulting/Medical Billing Business that is dedicated to educating, consulting, and overall improving the "financial health" of your medical practice.

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