Each 1 mg dose of leucovorin calcium (Avyxa brand) given by injection

Avyxa is a branded formulation of leucovorin calcium (folinic acid), a reduced folate derivative used to enhance the cytotoxic effects of fluoropyrimidines (e.g., 5-fluorouracil) in colorectal cancer treatment and to rescue normal cells from methotrexate toxicity. This code is billed per 1 mg of the drug administered via injection. It is distinct from other leucovorin formulations and is specific to the Avyxa brand.

Use this code when Avyxa (leucovorin calcium) is administered by injection in the outpatient or physician office setting, most commonly as part of chemotherapy regimens such as FOLFOX or FOLFIRI for colorectal cancer, or as high-dose methotrexate rescue therapy. Documentation should confirm the specific brand name Avyxa, the dose administered in milligrams, and the route of administration. This code is typically reported in conjunction with the administration CPT code (e.g., 96365–96368) and the applicable chemotherapy drug codes.

• Brand specificity is critical: Do not substitute this code for other leucovorin calcium codes (e.g., J0640 for generic leucovorin calcium); payers may deny claims if the administered brand does not match the billed code. Verify the medication label confirms Avyxa.
• Units matter: Bill one unit per 1 mg administered; accurately calculate total milligrams from the medical record to avoid underbilling or overbilling. Dose rounding policies vary by payer.
• Payer coverage: As a branded product with a C-code designation, coverage may be limited to hospital outpatient (OPPS) settings under Medicare; verify payer-specific formulary and coverage policies before billing in physician office settings, where J-code equivalents may be required instead.