Billing and Coding: Bevacizumab and biosimilars

This policy specifies HCPCS/CPT coding and billing rules for bevacizumab and its biosimilars for Part A and Part B claims, distinguishing non-ophthalmologic (use J9035 and 10 mg multiples) and ophthalmologic administrations (use C9142/J9035/Q5107/Q5118 with one unit per eye, or C9257 at 0.25 mg in ASCs). Claims must include correct site modifiers (RT/LT/50), intravitreal injections require CPT 67028, billing units must reflect actual dose increments, and off-label uses require support from FDA labeling or recognized compendia; claims inconsistent with these rules may be returned or denied.

"For Part B MAC non-ophthalmologic administration, report intravenous bevacizumab with HCPCS code J9035 (injection, bevacizumab, 10 mg); bill units reflecting multiples of 10 mg provided."

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