## **What is this service?**
HCPCS Code Q5107 refers to the injection of bevacizumab-awwb, a biosimilar of bevacizumab known as MVASI, at a dosage of 10 mg. This service is used primarily for treatment of multiple metastatic and malignant cancers, including metastatic renal cell carcinoma, metastatic colorectal cancer, metastatic cervical cancer, hepatocellular (liver) carcinoma, malignant neoplasms, and primary peritoneal cancer. It also has indications for various central nervous system cancers such as recurrent glioblastoma and metastatic spine tumors, and other soft tissue cancers.
The injection of bevacizumab-awwb biosimilar (MVASI) is medically necessary in cases where patients have relevant diagnoses including but not limited to metastatic spine tumors, colorectal cancer, cervix uteri cancer, unspecified kidney cancer, colon cancer, liver cell carcinoma, and other overlapping or unspecified malignant sites. It is used often in combination with chemotherapy regimens such as intravenous fluorouracil-based and fluoropyrimidine oxaliplatin-based chemotherapy. Treatment with this biosimilar requires documented medical necessity based on diagnosis, prior treatment response, and specific contraindications or intolerances to preferred bevacizumab products.
Beyond oncology, bevacizumab products (including biosimilars such as MVASI) have also been studied in ophthalmology for conditions like retinal vein occlusion, though these uses are considered off-label and not captured under HCPCS Q5107.
## **Documentation requirements**
To bill HCPCS Code Q5107 for injection of bevacizumab-awwb biosimilar (MVASI), documentation should include:
- Documentation of medical necessity supporting the use of bevacizumab-awwb for the patient's cancer treatment.
- Details of the dosage administered (units of 10 mg), consistent with the MVASI product label and local payer policies.
- Documentation of the related administration procedure, with use of CPT codes representing the intravenous infusion performed.
- Any drug wastage should be recorded in the medical records and billed separately if applicable, using the appropriate modifier (e.g., -JW) as per payer guidelines.
- Documentation should reflect moderate-level medical decision-making, including multiple diagnoses or medication management.
- Use of appropriate revenue codes for drugs requiring detailed coding (such as 0636 for Medicare).
- Physician or provider identifiers and service dates as per claim form requirements.
## **Billing requirements**
Billing requirements for HCPCS Code Q5107 injection of bevacizumab-awwb biosimilar (MVASI), 10 mg, include the following:
- Report Q5107 with the appropriate unit measurement where 1 billable unit = 10 mg of bevacizumab-awwb.
- Use the correct ICD-10-CM diagnosis code(s) that correspond to the patient's malignant or metastatic cancer diagnosis to support medical necessity.
- Submit billing claims using applicable CPT codes for chemotherapy administration, such as 96413 (initial infusion up to 1 hour), 96415 (each additional hour), or 96417 (each additional sequential infusion for different drugs).
- Document dosage units administered and any wastage. Wastage may be billed separately using the -JW modifier according to payer policies.
- Submit outpatient claims via appropriate claim forms such as UB-04 or electronic 837I format depending on the setting.
- Use relevant revenue codes for drug billing, such as Medicare's 0636 (drugs requiring detailed coding) or general pharmacy revenue codes for other payers.
- Ensure the billing reflects a single service line per drug administration; multiple claim lines for the same drug dose may be denied.
- Follow payer-specific preauthorization or coverage guidelines as bevacizumab biosimilars may require prior approval.
- Include detailed documentation supporting the use of Q5107 in patient medical records to comply with billing audits and payer policies.
Be cautious when coding diagnoses described as of uncertain behavior. These are generally not FDA-approved indications for bevacizumab-awwb and may require payer-specific review or prior authorization to avoid denials.
## **Other relevant codes**
- **Q5118** - Bevacizumab-bvzr, biosimilar, 10 mg
- **Q5126** - Bevacizumab-maly, biosimilar, 10 mg
- **Q5129** - Bevacizumab-adcd, biosimilar, 10 mg
- **J9035** - Reference bevacizumab injection, 10 mg
Frequently asked questions
