Ranibizumab-leyk (Nufymco) biosimilar intravitreal injection, billed per 0.1 mg dose

Ranibizumab-leyk (Nufymco) is an FDA-approved biosimilar to the reference product ranibizumab (Lucentis), a VEGF-A inhibitor administered via intravitreal injection. This code is billed per 0.1 mg of the biosimilar product and is used in the treatment of retinal neovascular conditions. It is distinct from the reference biologic and other ranibizumab biosimilars, each of which carries its own unique HCPCS code.

This code applies when ranibizumab-leyk (Nufymco specifically) is administered intravitreally for conditions such as neovascular (wet) age-related macular degeneration (AMD), diabetic macular edema (DME), diabetic retinopathy, or macular edema following retinal vein occlusion. Documentation must confirm the specific biosimilar product dispensed (not just "ranibizumab"), the dose in mg, and the indication. Payer coverage policies for biosimilars may vary, and prior authorization is commonly required.

• Product specificity is critical: Do not interchange this code with the reference biologic ranibizumab (Lucentis) or other ranibizumab biosimilars; the NDC on the claim must match Nufymco to support this code.
• Dose-based billing: The standard intravitreal dose is 0.5 mg (report 5 units) or 0.3 mg for DME (report 3 units); confirm the administered dose in the procedure note before determining units billed.
• Pair with the appropriate administration code: Report the intravitreal injection procedure code (e.g., CPT 67028) separately; verify payer policy on bundling, as some payers may require the drug and administration on the same claim line or may bundle them.