Procrit J0885 EJ

robbiehogstad

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Medicare is denying these claims for a mod? And or dx code? Does anyone have any information on this code? Is anyone else having issues with this? Any help would be GREAT!!!! :D
 

robbiehogstad

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Navarre, FL
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HI Thank you!!

It states the mod is wrong -- we were advised to use a EC Mod or a EJ Mod both are not correct.

The dx codes arange from 238.75, 285.9, 780.79, 208.07, 782.3 and last 250.00

I'm completely lost on this one I have no idea.

Thank you for your reply.

:eek:
 

pamike

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Effective 1/1/08 Medicare requires the Modifier EA, EB or EC be applied to this J code. If not on there it willbe denied as unprocessable lacking the required modifiers.
EA = ESA, Anemia, chemo induced
EB = ESA, anemia, radio-induced
EC = Esa, anemai, non chemo/radio

Hope this helps
 

CC5657

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I work in a Nephrology office that give Procrit injections. When we bill a patient with medicare, we use mod. EC with the J0885. If the patient is seeing the doctor, use -25 with the E/M code & EC with J0885. As for the DX codes, we need to use 285.21 as the 1st dx & the renal stage as 2nd code. We never have a problem getting paid.
 
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