MAR 15, 2022
Billing Silicon-free Avastin
I have a question regarding billing silicon-free Avastin, the syringes come as Bevacizumab 2.5 mg/0.1 mL but only 1.25 mg is injected into the eye. Should the other 1.25 be billed as J3590 JW?
The silicone-free syringes are prepared with overfill to allow the needle to primed prior to the injection. Overfill, according to Medicare, is not considered wastage and should not be reported with -JW modifier. Include in your documentation the dosage injected, 1.25 mg, and that the overfill medication was discarded.
The coding would be the appropriate Healthcare Common Procedure Coding System (HCPCS) code for Avastin for the payer, 1 unit and report in item 19 the medication name (bevacizumab (Avastin)) and dosage (1.25 mg/0.05ml).