Coding question -- hcpcs j9299 nivolumab

ALEX007

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Good morning,

I have a situation.

The claim was billed to Medicare as follows:

J9299 200mg
J9299 40mg

Medicare paid the 40mg and denied the J9299 200mg as duplicate.

The drugs were in x2 separate vials (x2 NDC). Per a convo held with Medicare, I was advised to append a modifier on the 200mg.

If so, which modifier should I append? In summary, how should I resubmit the 200mg so that Medicare would reprocess and issue payment?

Thank you in advance. :)
 
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