In Coding
Jun 10th, 2011
What’s the difference between bevacizumab (Avastin) and ranibuzumab (Lucentis)? Both are cancer drugs used for the treatment of “wet” age-related macular degeneration (AMD) with similar effects, according to a government study funded by the National Eye Institute. “At 1 year, bevacizumab and ranibuzumab had equivalent effects on visual acuity when administered according to t...
In Billing
Feb 11th, 2011
Effective for services rendered on or after Feb. 1, NHIC, Corp. will allow no greater than two units of HCPCS Level II code J9035 Injection, bevacizumab, 10 mg per patient per date of service. This accommodates right and left eyes being treated on the same date of service. Literature indicates, however, that the anticipated dosage is ...
In Coding
Jan 14th, 2011
The U.S. Food and Drug Administration (FDA) is recommending removing the breast cancer indication for Avastin (bevacizumab). To date, however, payers aren’t saying they will discontinue coverage. Some payers, in fact, are taking the National Comprehensive Cancer Network’s (NCCN) word over the FDA’s. According to Bloomberg Businessweek, several major insurers, including Wellpoint ...
In CMS
Jan 18th, 2010
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 ...
In CMS
Oct 19th, 2009
Health care providers in Colorado, New Mexico, Oklahoma and Texas submitting claims to TrailBlazer Health Enterprises should be aware of revisions the jurisdiction 4 (J4) Part A and Part B Medicare Administrative Contractor (A/B MAC) made, Oct. 5, to two local coverage determinations (LCD). The revisions were made in response to a recent addition to the list ...