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  • Correct Coding for Susvimo

    Question: What is the correct coding for Susvimo implantation, initial fill and refill-exchange procedures? 

    Answer: Effective July 1, a permanent HCPCS code has been assigned to Susvimo:  

    J2779, Injection, ranibizumab, via intravitreal implant (Susvimo), 0.1 mg. 

    There are specific recommendations that should be followed and differ from other intravitreal injections.

    Initial Fill and Implant Procedure, Performed in an ASC or Hospital Outpatient Facility 

    Facility bills:

    CPT code 67027, implantation of intravitreal drug delivery system, includes concomitant removal of vitreous

    J2779        20 units

    J2779-JW     80 units

    Physician bills: 

    CPT code 67027, append anatomical modifier, -RT or –LT

    Procedure note should state: 2 mg/0.02 mL used and 8 mg/0.08 mL wasted

    Refill-Exchange Procedure, Performed in an Office Setting

    CPT code 67028, append anatomical modifier, -RT or –LT

    J2779    100 units

    Report NDC in 5-4-2 format in item 24a of the CMS-1500, 50242-0078-12

    Procedure note should state: Withdrew the entire contents of the Susvimo vial into a syringe to the 0.1 mL dose mark. The entire contents of the syringe (0.1 mL) were used to flush the medication and provide the appropriate 2 mg continuous dosage into the implant. No wastage remained after the refill procedure was completed. 
    HCPCS code J2779 is included in the CMS ASP Pricing File for July 2022.