Forget Q2024, J9035 is Back
It was a season of discontent when the Centers for Medicare & Medicaid Services (CMS) announced last fall the creation of HCPCS Level II code Q2024 Injection, bevacizumab, 0.25 mg. What was wrong with perfectly good J9035 Injection, bevacizumab, 10 mg, providers asked.
CMS reasoned that Q2024’s lower dose amount (0.25 mg vs. J9035’s 10 mg) was more appropriate for ophthalmologists, but the agency eventually conceded to the majority rule. CMS deleted Q2024 effective Jan. 1, Q2024—just three months after implementing the code.
Contractors were instructed by CMS to post the following message on their websites:
“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.”
Note the key words in this statement: “… for payment of non-outpatient hospital claims.” What CMS did was reinstate Chemotherapy Drugs code J9035 and give Q2024 a new identity—also known as C9257 Injection, bevacizumab, 0.25 mg. You’ll find this new code (with a nonpass-through status indicator) under the Outpatient Perspective Payment System (PPS) category in HCPCS 2010.