May 12, 2023

Guidance for Billing Avastin for Ophthalmic Use

Health Partners Plans would like to provide guidance to our network regarding billing Avastin for Ophthalmic indications. The table below provides accepted coding and requirements for reimbursement consideration for each.

Code	Definition	Line of Business	Auth Required	Medical Record Review
C9257	Injection, bevacizumab, 0.25 mg	Medicare	Yes	No
C9257	Injection, bevacizumab, 0.25 mg	Medicaid and CHIP	No	No
J7999	Compounded drug, not otherwise classified	All	Yes	Yes

Please note that J9035 – Injection, bevacizumab, 10 mg, is still accepted for cancer indications and will require prior authorization through eviCore for all HPP’s product lines.

If you have any questions, please contact the Provider Services Helpline at 1-888-991-9023 (Monday to Friday, 9 a.m. – 5:30 p.m.).

Sub-navProviders

Guidance for Billing Avastin for Ophthalmic Use