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Avastin J3490 or J9035???

  1. Default Avastin J3490 or J9035???
    Medical Coding Books
    We have been submitting J3490 for Avastin with NDC and dosage attached. We have been advised by one insurance company that we must use J9035 instead. Any input appreciated.

  2. #2
    Nashville, Tennessee
    Default avastin
    It depends on the carrier. Cahaba tells us to use J9035 and put dosing information. Cigna reqires C9257 even though this is for Surgery Center usage. Blue Cross is the nightmare. They give you a precert for J9035 but then denies it or only pays you $7.00 to 8.00. BCBS states they want you to use J3059. So it is really up to the payor so be sure to talk with each one. I know this does not help very much. It really should not be this hard.

  3. Default
    Please tell me how you have a NDC number for a unlisted code J3490? Avastin for intravitreal use is a compounded drug and it does not have a NDC number.
    J9035 on the other hand is a real code for the colorectal cancer Avastin at 10 mg I believe.

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