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ICD-10 Code Finder

Use the interactive code finder to quickly find the new ICD-10 codes for EYLEA® (aflibercept) Injection. To begin, simply answer the following short questions.

The coding information discussed here is provided for informational purposes only, is subject to change, and should not be construed as legal advice. The codes listed here may not apply to all patients or to all health plans; providers should exercise independent clinical judgment when selecting codes and submitting claims to accurately reflect the services and products furnished to a specific patient.

Our interactive code finder is now updated with new ICD-10 Codes.
Use these codes on or after October 1, 2016.

What is the level of severity of the patient’s wet age-related macular degeneration?

With active choroidal neovascularization With inactive choroidal neovascularization With inactive scar Stage unspecified

Which eye is being treated for wet age-related macular degeneration?

Right Eye
ICD‑10* Code: H35.321
Exudative age-related macular degeneration, right eye, with
Left Eye
ICD‑10* Code: H35.322
Exudative age-related macular degeneration, left eye, with
Bilateral
ICD‑10* Code: H35.323
Exudative age-related macular degeneration, bilateral, with
Unspecified Eye
ICD‑10* Code: H35.329
Exudative age-related macular degeneration, unspecified eye,
Administration Procedure
CPT Codes
Description
67028-LT Intravitreal injection of a pharmacologic agent (separate procedure): LT indicates left eye injection
67028-RT Intravitreal injection of a pharmacologic agent (separate procedure): RT indicates right eye injection
67028-50 Intravitreal injection of a pharmacologic agent (separate procedure): 50 indicates bilateral injection
Drug Codes Description
HCPCS J0178 Injection, aflibercept, 1 mg. With the 1-mg descriptor, it is appropriate to indicate “2” billing units for each 2-mg injection on the claim form
NDC§ 61755-0005-02 One single-use, sterile, 3-mL, glass vial designed to deliver 0.05 mL of 40 mg/mL EYLEA

What type of diabetes mellitus does the patient have?

Diabetes mellitus due to underlying condition with... Drug or chemical induced diabetes mellitus with... Type 1 diabetes mellitus with... Type 2 diabetes mellitus with... Other specified diabetes mellitus with...

What is the level of severity of the patient’s diabetic retinopathy?

Mild nonproliferative diabetic retinopathy with macular edema Moderate nonproliferative diabetic retinopathy with macular edema Severe nonproliferative diabetic retinopathy with macular edema Proliferative diabetic retinopathy with macular edema

Which eye is being treated for diabetic retinopathy?

Right Eye
ICD‑10* Code: .11
, right eye
Left Eye
ICD‑10* Code: .12
, left eye
Bilateral
ICD‑10* Code: .13
, bilateral
Unspecified Eye
ICD‑10* Code: .19
, unspecified eye
Administration Procedure
CPT Codes
Description
67028-LT Intravitreal injection of a pharmacologic agent (separate procedure): LT indicates left eye injection
67028-RT Intravitreal injection of a pharmacologic agent (separate procedure): RT indicates right eye injection
67028-50 Intravitreal injection of a pharmacologic agent (separate procedure): 50 indicates bilateral injection
Drug Codes Description
HCPCS J0178 Injection, aflibercept, 1 mg. With the 1-mg descriptor, it is appropriate to indicate “2” billing units for each 2-mg injection on the claim form
NDC§ 61755-0005-02 One single-use, sterile, 3-mL, glass vial designed to deliver 0.05 mL of 40 mg/mL EYLEA

Which eye is being treated for central retinal vein occlusion?

Right Eye
ICD‑10* Code: H34.8110
Central retinal vein occlusion, right eye, with macular edema
Left Eye
ICD‑10* Code: H34.8120
Central retinal vein occlusion, left eye, with macular edema
Bilateral
ICD‑10* Code: H34.8130
Central retinal vein occlusion, bilateral, with macular edema
Unspecified Eye
ICD‑10* Code: H34.8190
Central retinal vein occlusion, unspecified eye, with macular edema
Administration Procedure
CPT Codes
Description
67028-LT Intravitreal injection of a pharmacologic agent (separate procedure): LT indicates left eye injection
67028-RT Intravitreal injection of a pharmacologic agent (separate procedure): RT indicates right eye injection
67028-50 Intravitreal injection of a pharmacologic agent (separate procedure): 50 indicates bilateral injection
Drug Codes Description
HCPCS J0178 Injection, aflibercept, 1 mg. With the 1-mg descriptor, it is appropriate to indicate “2” billing units for each 2-mg injection on the claim form
NDC§ 61755-0005-02 One single-use, sterile, 3-mL, glass vial designed to deliver 0.05 mL of 40 mg/mL EYLEA

Which eye is being treated for branch retinal vein occlusion?

Right Eye
ICD‑10* Code: H34.8310
Tributary (branch) retinal vein occlusion, right eye, with macular edema
Left Eye
ICD‑10* Code: H34.8320
Tributary (branch) retinal vein occlusion, left eye, with macular edema
Bilateral
ICD‑10* Code: H34.8330
Tributary (branch) retinal vein occlusion, bilateral, with macular edema
Unspecified Eye
ICD‑10* Code: H34.8390
Tributary (branch) retinal vein occlusion, unspecified eye, with macular edema
Administration Procedure
CPT Codes
Description
67028-LT Intravitreal injection of a pharmacologic agent (separate procedure): LT indicates left eye injection
67028-RT Intravitreal injection of a pharmacologic agent (separate procedure): RT indicates right eye injection
67028-50 Intravitreal injection of a pharmacologic agent (separate procedure): 50 indicates bilateral injection
Drug Codes Description
HCPCS J0178 Injection, aflibercept, 1 mg. With the 1-mg descriptor, it is appropriate to indicate “2” billing units for each 2-mg injection on the claim form
NDC§ 61755-0005-02 One single-use, sterile, 3-mL, glass vial designed to deliver 0.05 mL of 40 mg/mL EYLEA
For more information or help with the reimbursement process, or if you have questions, contact your RBM or EYLEA4U® at 1-855-EYLEA4U (1-855-395-3248), Option 4, Monday-Friday 9AM-8PM Eastern Time
IMPORTANT SAFETY INFORMATION
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  • EYLEA® (aflibercept) Injection is contraindicated in patients with ocular or periocular infections, active intraocular inflammation, or known hypersensitivity to aflibercept or to any of the excipients in EYLEA.
  • Intravitreal injections, including those with EYLEA, have been associated with endophthalmitis and retinal detachments. Proper aseptic injection technique must always be used when administering EYLEA. Patients should be instructed to report any symptoms suggestive of endophthalmitis or retinal detachment without delay and should be managed appropriately. Intraocular inflammation has been reported with the use of EYLEA.
  • Acute increases in intraocular pressure have been seen within 60 minutes of intravitreal injection, including with EYLEA. Sustained increases in intraocular pressure have also been reported after repeated intravitreal dosing with VEGF inhibitors. Intraocular pressure and the perfusion of the optic nerve head should be monitored and managed appropriately.
  • There is a potential risk of arterial thromboembolic events (ATEs) following intravitreal use of VEGF inhibitors, including EYLEA. ATEs are defined as nonfatal stroke, nonfatal myocardial infarction, or vascular death (including deaths of unknown cause). The incidence of reported thromboembolic events in wet AMD studies during the first year was 1.8% (32 out of 1824) in the combined group of patients treated with EYLEA. The incidence in the DME studies from baseline to week 52 was 3.3% (19 out of 578) in the combined group of patients treated with EYLEA compared with 2.8% (8 out of 287) in the control group; from baseline to week 100, the incidence was 6.4% (37 out of 578) in the combined group of patients treated with EYLEA compared with 4.2% (12 out of 287) in the control group. There were no reported thromboembolic events in the patients treated with EYLEA in the first six months of the RVO studies.
  • Serious adverse reactions related to the injection procedure have occurred in <0.1% of intravitreal injections with EYLEA including endophthalmitis and retinal detachment.
  • The most common adverse reactions (≥5%) reported in patients receiving EYLEA were conjunctival hemorrhage, eye pain, cataract, vitreous floaters, intraocular pressure increased, and vitreous detachment.
IMPORTANT PRESCRIBING INFORMATION

EYLEA® (aflibercept) Injection is indicated for the treatment of patients with

  • Neovascular (Wet) Age-related Macular Degeneration (AMD): The recommended dose is 2 mg administered by intravitreal injection every 4 weeks (monthly) for the first 12 weeks (3 months), followed by 2 mg once every 8 weeks (2 months). Although EYLEA may be dosed as frequently as 2 mg every 4 weeks (monthly), additional efficacy was not demonstrated in most patients when EYLEA was dosed every 4 weeks compared to every 8 weeks. Some patients may need every 4 week (monthly) dosing after the first 12 weeks (3 months).
  • Macular Edema following Retinal Vein Occlusion (RVO): The recommended dose is 2 mg administered by intravitreal injection every 4 weeks (monthly).
  • Diabetic Macular Edema (DME) and Diabetic Retinopathy (DR) in Patients with DME: The recommended dose is 2 mg administered by intravitreal injection every 4 weeks (monthly) for the first 5 injections, followed by 2 mg once every 8 weeks (2 months). Although EYLEA may be dosed as frequently as 2 mg every 4 weeks (monthly), additional efficacy was not demonstrated in most patients when EYLEA was dosed every 4 weeks compared to every 8 weeks. Some patients may need every 4 week (monthly) dosing after the first 20 weeks (5 months).

Please see the full Prescribing Information for EYLEA.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

The information provided in this site is intended only for healthcare professionals in the United States. The products discussed herein may have different product labeling in different countries.



EYLEA and EYLEA4U are registered trademarks of Regeneron Pharmaceuticals, Inc.

777 Old Saw Mill River Road, Tarrytown, NY 10591
US-LEA-1934

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