Wiki Billing for Syfovre injection to Medicare

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jmrt3

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Our Ophthalmology group plans to start using Syfovre. My local MAC, FCSO, does not have policy on this new drug, and there is no HCPCS code as of yet. Has anyone billed Syfovre to Medicare, FCSO using C9399, J3490, or J3590? Any information you can share on which drug code is being used on claims or if denials have been received for the drug is most appreciated. Thank you!
 
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We use J3490 JZ prior to the new code J2781 JZ that is effective 10/1/23. You should get a drug rep to bring you lunch and get you all the details. We are having amazing luck using bilateral codes being covered as well. Yes to all of this to Medicare - use the same NDC for J3490 JZ :)
 
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