DEC 01, 2022
Avastin Coding and Billing
How often can intraocular bevacizumab (Avastin) be billed? I have read a few things that state 28 days but at one point was told 31 days.
Answer:Most payers follow the 28-day rule for intravitreal injections of Avastin. Confirm the frequency per the Medicare policies at
aao.org/lcds. For example, Noridian's “Billing and Coding: Intraocular Bevacizumab (A53009)” policy states “treatment more frequently than approximately every four weeks (in a given eye) would be expected to be very rare and require explicit documentation justifying that use.” Commercial and Medicaid plans may have their own policies and frequency edits.