Coding Information
| Coding1,2 | ||
|---|---|---|
| HCPCS Code | Q5126 | Injection, bevacizumab-maly, biosimilar, (ALYMSYS), 10 mg |
| OPPS Status | G | Indicates pass-through payment |
| Coding1,2 | HCPCS Code |
|---|---|
| Q5126 | |
| Injection, bevacizumab-maly, biosimilar, (ALYMSYS), 10 mg |
| Coding1,2 | OPPS Status |
|---|---|
| G | |
| Indicates pass-through payment |
| Indication | ICD-10-CM Code Range Descriptor | ICD-10-CM Code Range |
|---|---|---|
| Metastatic colorectal cancer, in combination with fluoropyrimidine-irinotecan- or fluoropyrimidine-oxaliplatin-based chemotherapy for second-line treatment in patients who have progressed on a first-line bevacizumab product-containing regimen Limitations of use: ALYMSYS is not indicated for adjuvant treatment of colon cancer3 | Metastatic colorectal cancer | C18.0-C18.9; C19; C204 |
| Unresectable, locally advanced, recurrent, or metastatic non-squamous non-small cell lung cancer, in combination with carboplatin and paclitaxel for first-line treatment3 | Metastatic nonsquamous non-small cell lung cancer | C34.00-C34.925 |
| Recurrent glioblastoma in adults3 | Glioblastoma | C71.0-C71.96 |
| Metastatic renal cell carcinoma in combination with interferon alfa3 | Metastatic renal cell carcinoma | C64.1-C64.9; C65.1-C65.97 |
| Persistent, recurrent, or metastatic cervical cancer, in combination with paclitaxel and cisplatin or paclitaxel and topotecan3 | Persistent, recurrent, or metastatic cervical cancer | C53, C530.0, C53.1, C53.8, C53.98 |
| Epithelial ovarian, fallopian tube, or primary peritoneal cancer in combination with paclitaxel, pegylated liposomal doxorubicin, or topotecan for platinum-resistant recurrent disease in patients who received no more than 2 prior chemotherapy regimens3 | Epithelial ovarian, fallopian tube, or primary peritoneal cancer | C48.0-C48.8; C56.1-C56.9; C57.00-C57.22; C57.3-C57.89 |
| Indication | Metastatic colorectal cancer, in combination with fluoropyrimidine-irinotecan- or fluoropyrimidine-oxaliplatin-based chemotherapy for second-line treatment in patients who have progressed on a first-line bevacizumab product-containing regimen Limitations of use: ALYMSYS is not indicated for adjuvant treatment of colon cancer3 |
|---|---|
| ICD-10-CM Code Range Descriptor | Metastatic colorectal cancer |
| ICD-10-CM Code Range | C18.0-C18.9; C19; C204 |
| Indication | Unresectable, locally advanced, recurrent, or metastatic non-squamous non-small cell lung cancer, in combination with carboplatin and paclitaxel for first-line treatment3 |
|---|---|
| ICD-10-CM Code Range Descriptor | Metastatic nonsquamous non-small cell lung cancer |
| ICD-10-CM Code Range | C34.00-C34.925 |
| Indication | Recurrent glioblastoma in adults3 |
|---|---|
| ICD-10-CM Code Range Descriptor | Glioblastoma |
| ICD-10-CM Code Range | C71.0-C71.96 |
| Indication | Metastatic renal cell carcinoma in combination with interferon alfa3 |
|---|---|
| ICD-10-CM Code Range Descriptor | Metastatic renal cell carcinoma |
| ICD-10-CM Code Range | C64.1-C64.9; C65.1-C65.97 |
| Indication | Persistent, recurrent, or metastatic cervical cancer, in combination with paclitaxel and cisplatin or paclitaxel and topotecan3 |
|---|---|
| ICD-10-CM Code Range Descriptor | Persistent, recurrent, or metastatic cervical cancer |
| ICD-10-CM Code Range | C53, C530.0, C53.1, C53.8, C53.98 |
| Indication | Epithelial ovarian, fallopian tube, or primary peritoneal cancer in combination with paclitaxel, pegylated liposomal doxorubicin, or topotecan for platinum-resistant recurrent disease in patients who received no more than 2 prior chemotherapy regimens3 |
|---|---|
| ICD-10-CM Code Range Descriptor | Epithelial ovarian, fallopian tube, or primary peritoneal cancer |
| ICD-10-CM Code Range | C48.0-C48.8; C56.1-C56.9; C57.00-C57.22; C57.3-C57.89 |