2025 HCPCS code C9257

Injection of bevacizumab, 0.25 mg.

Adhere to the most recent HCPCS coding guidelines.Accurate documentation is crucial for proper coding and reimbursement.

Modifiers may be applicable based on the place of service, administration method, and other factors (e.g., RT, LT, 50, etc.).

Medical necessity for bevacizumab is determined based on the patient's specific diagnosis and condition, in alignment with established clinical guidelines.Documentation should support the rationale for the treatment, and it must meet payer-specific criteria for coverage.

Administration of the bevacizumab injection by a qualified healthcare professional (physician, nurse, etc.).Monitoring the patient for adverse reactions during and after administration.

IMPORTANT Other codes may be used depending on the indication (ophthalmologic vs. oncologic) and place of service. For ophthalmologic use, codes such as J9035, C9142, Q5107, Q5118, or Q5126 may be applicable.The use of code C9257 is often associated with CPT code 67028 for intravitreal injection in ophthalmologic settings.

In simple words: This code is for a shot of the medicine bevacizumab (0.25 mg), often used to treat cancer or eye problems.The shot is given into a vein. The time it takes to give the shot may vary.

HCPCS code C9257 represents the administration of a 0.25 mg injection of bevacizumab, a monoclonal antibody used in the treatment of various cancers and certain ophthalmologic conditions.The administration method is typically intravenous infusion. The initial dose may take approximately 90 minutes, while subsequent doses may take 30-60 minutes, depending on the patient's response and the absence of adverse effects.This code is specifically for the 0.25mg dosage and should not be used for other dosages or formulations.

Example 1: A patient with metastatic colon cancer receives an intravenous infusion of bevacizumab (0.25 mg) as part of their chemotherapy regimen in an outpatient oncology clinic., A patient with age-related macular degeneration undergoes an intravitreal injection of bevacizumab (0.25 mg) in an ophthalmologist's office. CPT code 67028 is also billed., A patient with a retinal vascular condition receives an intravitreal injection of bevacizumab (0.25 mg) in an ambulatory surgical center (ASC).Modifier may be required to specify the side of injection.

Complete medical history, diagnosis, details of the administration procedure (route, time, any adverse events), and the specific dosage administered.For ophthalmologic use, supporting documentation demonstrating medical necessity is required.

** Always check for payer-specific coding and billing guidelines.This code should only be used for the specified 0.25mg dosage.Consult current medical billing resources and professional coding references for the most up-to-date information.

  • Payment Status: Active
  • Modifier TC rule: Not applicable.This HCPCS code is for drug administration, not a technical component.
  • Specialties:Oncology, Ophthalmology
  • Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center, Hospital Inpatient
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