Wiki J2785 Modifier?

[drsmith1999@gmail.com]

I am getting denials form Humana Medicare Replacement saying I need a modifier for J2785. Anyone having this issue?

 

[xXxPARAGONxXx]

I am getting denials form Humana Medicare Replacement saying I need a modifier for J2785. Anyone having this issue?

Probably referring to JW and JZ modifiers.

https://www.cms.gov/medicare/medica...loutpatientpps/downloads/jw-modifier-faqs.pdf
https://www.cms.gov/files/document/mm13056-new-jz-claims-modifier-certain-medicare-part-b-drugs.pdf

 

[drsmith1999@gmail.com]

Probably referring to JW and JZ modifiers.

https://www.cms.gov/medicare/medica...loutpatientpps/downloads/jw-modifier-faqs.pdf
https://www.cms.gov/files/document/mm13056-new-jz-claims-modifier-certain-medicare-part-b-drugs.pdf

Thank you for the link. We are not using the JW and JZ modifier. I will look into this.

 

[va2flcoder]

I have found that some insurances consider the JZ as an inappropriate modifier, which I don't feel is right. I verified with the clinic and they are not wasting any drug. Still trying to find something that will get past the edit, but I am not succeeding!

 

[xXxPARAGONxXx]

I have found that some insurances consider the JZ as an inappropriate modifier, which I don't feel is right. I verified with the clinic and they are not wasting any drug. Still trying to find something that will get past the edit, but I am not succeeding!

Have you submitted the claim with modifier -JZ yet?

 

[drsmith1999@gmail.com]

Have you submitted the claim with modifier -JZ yet?

I have to some corrected claims that was denied. I have not had any denials from Medicare but some from the Medicare Advantage Plans.

 

[acartercpc]

according to the link someone posted above, codes with an indicator n or n1 are excluded from needing these modifiers, so why is humana and UHC denying for the modifier? what am i missing?