Ob-Gyn Coding Alert

Question: My practice employs an oncology ob-gyn, and I heard CMS released a new HCPCS code for a cancer drug. What is it, and how much will Medicare reimburse?

Texas Subscriber

Answer: CMS did release a HCPCS code for Bevacizumab, a cancer drug. The new code will be effective as of Oct. 1:

• Q2024 -- Injection, Bevacizumab, 0.25 mg

This drug is used in combination with other chemoagents or treatments to stop the body from forming new blood cells that could otherwise feed a tumor. Physicians can use this drug with metastatic cancer only, and in 2008, the Food and Drug Administration (FDA) approved this drug for the treatment of metastatic breast cancer. Prior to that, the FDA approved it only for the treatment of metastic colon and non-small cell lung cancers. Recent studies indicate that this drug in combination with a second drug may be an effective treatment for recurrent ovarian tumors.

Currently, CMS has assigned Q2024 a procedure status of E, which means the code is excluded from the Physician Fee Schedule by regulation. Medicare Appeal Councils (MACs), however, may pay it under "reasonable charge procedures."

To read more about the new Bevacizumab injection code, visit www.cms.hhs.gov/MLNMattersArticles/downloads/MM6594.pdf.

-- The answers for Reader Questions and You Be the Coder provided by Melanie Witt, RN, CPC, COBGC, MA, an ob-gyn coding expert based in Guadalupita, N.M.