Wiki billing code J9395

[dwickware]

Hello,
I am needing help please how to bill drug code J9395 Faslodex to UHC Medicare Advantage split dose given on RT and LT buttock.

Thank you

 

[Cfsmith]

There are a few things about this. It does require the JZ/JW modifier. You have to make sure your units match the whole number based on the NDC. If the whole unit for that bottle is 10 mg, and you gave the patient only 6 mg, then you would add the JW to 4 mg on a separate line. If you gave the full 10 mg, then you would add the JZ on one line. This information is listed on the CMS website.

 

[dwickware]

Thank you
No waste billing split dose right and left buttock.This is the rejection I am receiving from UHC the JZ or JW modifier submitted is inappropriate. This is how I file the claim.
J9395 JZ
96402
J9395 JZ
96402 59

 

[trarut]

We bill fulvestrant as a single line for the total units & JZ modifier. We only bill a single administration code because the injections are given concurrently and there is no code for concurrent chemo.

ETA: The admin comment.

 

[dwickware]

Thank you