CMS Formally Reverses Decision on Avastin Coding

As reported previously, the Centers for Medicare & Medicaid Services (CMS) is reversing its decision on the use of HCPCS Code Q2024 Bevacizumab (Avastin) with place of service office.

CMS has instructed all Medicare Administrative Contractors (MACs) to advise physicians to return to the previous reporting practice for billing intraocular doses of Bevacizumab (Avastin) under the J series code AS OF NOW!

At this time, the MACs will NOT automatically reprocess claims for additional payment with dates of service on or after October 1, 2009 submitted with Q2024 or for claims submitted with an unlisted procedure code that the contractor changed to Q2024 during processing.

You will need to request that the claims be reopened.

Contractors have also been instructed to reprocess any claims from physicians for Avastin administered in their offices that were paid based on the Q2024 code if requested by the physician.

FYI, HCPCS code Q2024 will be deleted as of January 1, 2010.

For guidance on this issue, please contact us through the Third Party Insurance Help Program.