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Procrit J0885 EJ

  1. #1
    Fort Walton Beach, Florida
    Question Procrit J0885 EJ
    Medical Coding Books
    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!!!!

  2. #2
    Albany, New York
    What is the chart documentation in conjunction with the use of this drug?
    Karen Maloney, CPC
    Data Quality Specialist

  3. #3
    Fort Walton Beach, Florida
    Default 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.

  4. #4
    Pam Tienter, CPC, COC, CPC-P, CCS-P, CPMA, CPC-I
    National Advisory Board Member 2018-2021, Region 6 Great Lakes

  5. #5
    Albany, New York

    If the claims you are submitting with the "EJ" modifier on them are definitely subsequent (and not initial) claims, the issue may be with some of the diagnosis codes.

    Hope this helps........
    Karen Maloney, CPC
    Data Quality Specialist

  6. Default
    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

  7. #7
    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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