2025 HCPCS code Q5126

Injection, bevacizumab-maly, biosimilar, (Alymsys), 10 mg

Report this code only for Alymsys®, bevacizumab–maly, biosimilar. This code represents the supply of the drug. Check coding and individual payer guidelines to determine whether you can also report the administration of the drug. If the dose administered is only part of a single–dose container, and the remainder has to be discarded, you may be able to use modifier JW to report the discarded portion. Check payer guidelines.

Modifier JW may be applicable if a portion of the drug is discarded.

Medical necessity must be established based on the patient's specific diagnosis and treatment plan. This medication is often used for specific advanced or metastatic cancers when other treatments have not been successful or are not appropriate. Supporting documentation should clearly demonstrate why bevacizumab-maly is necessary for the patient's care. This can include documentation of failed prior therapies, contraindications to other treatments, or specific clinical guidelines that support the use of bevacizumab-maly for the patient's condition.

The recommended dosage of bevacizumab–maly (Alymsys®) varies based on the patient’s diagnosis, weight, and other therapies. Providers may prescribe this treatment for patients with colorectal cancer, which pertains to cancers of the colon (part of the large intestine) and the rectum (the end of the large intestines or bowel). Providers may prescribe this treatment for other types of cancer, as well. It is a vascular endothelial growth factor (VEGF) inhibitor.

In simple words: This code represents 10 milligrams of Alymsys, a medicine used to treat certain types of cancer. It's given through a vein and works by blocking a protein that helps tumors grow new blood vessels.

This code represents 10 mg of bevacizumab–maly, sold as Alymsys®. It is a biosimilar monoclonal antibody typically administered intravenously to treat metastatic colorectal cancer and other cancers.

Example 1: A patient with metastatic colorectal cancer receives 5 mg/kg of bevacizumab-maly every two weeks along with intravenous fluorouracil., A patient with non-small cell lung cancer receives a specific dose of bevacizumab-maly in combination with other chemotherapy drugs. , A patient with glioblastoma receives bevacizumab-maly as part of their treatment regimen.

Documentation should include the diagnosis, the dosage administered, the route of administration, and medical necessity for the use of bevacizumab-maly.

  • Specialties:Oncology, Hematology
  • Place of Service: Office, Outpatient Hospital, Inpatient Hospital, Ambulatory Surgical Center
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