|
Now approved for your members with Macular Edema following Retinal Vein Occlusion (RVO):
The first and only dual-pathway inhibitor in retinal disease1-5
|
|
|
|
|
Please refer to the billing and coding information below, and ensure your systems and policies are updated accordingly.
|
|
Sample Billing and Coding for Macular Edema following RVO
|
|
|
|
| TYPE | CODE | DESCRIPTION |
|---|
| ICD-10-CM | H34.8110 | Central retinal vein occlusion, right eye, with macular edema | | H34.8120 | Central retinal vein occlusion, left eye, with macular edema | | H34.8130 | Central retinal vein occlusion, bilateral, with macular edema | | H34.8190 | Central retinal vein occlusion, unspecified eye, with macular edema | | H34.8310 | Tributary (branch) retinal vein occlusion, right eye, with macular edema | | H34.8320 | Tributary (branch) retinal vein occlusion, left eye, with macular edema | | H34.8330 | Tributary (branch) retinal vein occlusion, bilateral, with macular edema | | H34.8390 | Tributary (branch) retinal vein occlusion, unspecified eye, with macular edema | | HCPCS Code | J2777 | Injection, faricimab-svoa, 0.1 mg | | 11-Digit NDC | 50242-0096-01 | 6 mg/0.05 mL single-dose vial |
|
|
|
|
|
These codes are not all-inclusive; appropriate codes can vary by patient, setting of care, and payer. Correct coding is the responsibility of the provider submitting the claim for the item or service. Genentech does not make any representation or guarantee concerning reimbursement or coverage for any service or item.
|
|
|
|
|
Existing codes for nAMD and DME have not changed
|
|
|
|
|
Indications
|
| VABYSMO (faricimab-svoa) is a vascular endothelial growth factor (VEGF) inhibitor and angiopoietin-2 (Ang-2) inhibitor indicated for the treatment of patients with Neovascular (Wet) Age-Related Macular Degeneration (nAMD),Diabetic Macular Edema (DME), and Macular Edema following Retinal Vein Occlusion (RVO). |
|
IMPORTANT SAFETY INFORMATION
|
|
Contraindications
|
| VABYSMO is contraindicated in patients with ocular or periocular infection, in patients with active intraocular inflammation, and in patients with known hypersensitivity to faricimab or any of the excipients in VABYSMO. |
|
Warnings and Precautions
|
|
•
|
|
Endophthalmitis and retinal detachments may occur following intravitreal injections. Patients should be instructed to report any symptoms suggestive of endophthalmitis or retinal detachment without delay, to permit prompt and appropriate management. |
|
•
|
|
Increases in intraocular pressure have been seen within 60 minutes of an intravitreal injection. |
|
•
|
|
There is a potential risk of arterial thromboembolic events (ATEs) associated with VEGF inhibition. |
|
•
|
|
Retinal vasculitis and/or retinal vascular occlusion, patients should be instructed to report any change in vision without delay. |
|
|
Adverse Reactions
|
| The most common adverse reactions (≥5%) reported in patients receiving VABYSMO were cataract (15%) and conjunctival hemorrhage (8%). |
|
You may report side effects to the FDA at (800) FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at (888) 835-2555.
|
|
Please see additional Important Safety Information in the full VABYSMO Prescribing Information.
|
|
|
|
| HCPCS=Healthcare Common Procedure Coding System; ICD-10-CM=International Classification of Diseases, 10th Revision, Clinical Modification; NDC=National Drug Code.
|
|
References: 1. VABYSMO [package insert]. South San Francisco, CA: Genentech, Inc; 2023. 2. Beovu® (brolucizumab) [package insert]. East Hanover, NJ: Novartis; 2023. 3. Eylea® (aflibercept) [package insert]. Tarrytown, NY: Regeneron Pharmaceuticals, Inc; 2023. 4. LUCENTIS® (ranibizumab) [package insert]. South San Francisco, CA: Genentech, Inc; 2023. 5. SUSVIMO™ (ranibizumab injection) [package insert]. South San Francisco, CA: Genentech, Inc; 2022.
|
|
|
|
|
|
VABYSMO is a registered trademark of Genentech, Inc., and the VABYSMO logo is a trademark of Genentech, Inc.
|
© 2023 Genentech USA, Inc.
1 DNA Way
South San Francisco, CA 94080-4990
All rights reserved.
|
|
|
|
