2025 HCPCS code J9035
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Drugs - Injection, bevacizumab Chemotherapy Drugs Feed
Injection, bevacizumab, 10 mg; one unit equals 10 mg.
Modifiers may apply depending on the circumstances of administration, such as the use of modifiers for multiple injections or specific administration sites.
Bevacizumab's medical necessity is established through the presence of a specific cancer diagnosis for which the drug is indicated.Documentation should justify the use of bevacizumab based on established treatment protocols and clinical guidelines.Payer-specific criteria should also be considered.
The clinical responsibility involves prescribing and administering bevacizumab, verifying appropriate patient diagnosis and medical necessity for the treatment, ensuring proper drug handling and administration techniques, monitoring the patient for adverse reactions, and documenting the administration and any relevant patient outcomes.
In simple words: This code is for the cancer medicine bevacizumab.One unit means 10 milligrams of the medicine given as an injection into a vein. This code only covers the cost of the medicine itself, not the injection.
HCPCS code J9035 represents the administration of bevacizumab, a cancer medication that inhibits cancer cell growth.One unit of this code corresponds to 10 mg of bevacizumab administered intravenously. This code solely represents the drug itself and not its administration. Bevacizumab is frequently used in combination with other cancer medications to treat various cancers, including certain brain tumors and cancers of the kidney, lung, colon, rectum, cervix, ovary, and fallopian tubes.The code should be reported in multiples of 10 mg to reflect the quantity administered.Note that for intraocular use, J3590 may be a more appropriate code.
Example 1: A 65-year-old male patient diagnosed with metastatic colon cancer receives 40 mg of bevacizumab intravenously as part of a chemotherapy regimen. Four units of J9035 would be reported (40 mg / 10 mg/unit = 4 units)., A 50-year-old female patient with renal cell carcinoma receives 20 mg of bevacizumab during a chemotherapy session.Two units of J9035 are reported (20mg / 10 mg/unit = 2 units)., A 70-year-old patient with glioblastoma receives 30mg of bevacizumab intravenously. Three units of J9035 are reported.
* Diagnosis code(s) supporting medical necessity for bevacizumab.* Documentation of the total dosage of bevacizumab administered.* Administration notes indicating intravenous route and date of administration.* Evidence of medical necessity, aligning with payer guidelines.
** This HCPCS code should only be used for the drug product; separate codes should be used for administration or other related services. Always consult payer-specific guidelines for any limitations or restrictions.
- RVU: RVUs are not directly associated with HCPCS codes. Reimbursement is determined by the payer's fee schedule and may vary based on factors such as place of service and other modifiers.CMS conversion factors are not applicable.
- Global Days : Not applicable. This is a drug code, not a procedure code with a global period.
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier is not applicable as J9035 represents the drug itself, not the administration procedure.
- Fee Schedule : Historical fee schedule data for J9035 can be obtained from payer-specific websites or fee schedule databases.Specific amounts and dates will vary depending on the payer and effective dates.
- Specialties:Oncology, Hematology
- Place of Service:Office, Hospital (Inpatient and Outpatient), Ambulatory Surgical Center