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Billing for J0588 Botox

  1. #1
    Default Billing for J0588 Botox
    Medical Coding Books
    I need to bill for 200 units of J0588 Botox injected. I just received a denial from Medicare saying that we can only bill up to 100 units per line of J0588 Botox. BUT.....when I resubmitted the claim on seperate lines, they denied the second line as a dup charge. I am really frustrated. Any suggestions?
    By the way.....when did this start? We have been billing on one line forever with no problems. And now this............

    Stacy Moch, CPC-A
    Oregon Neurology Associates

  2. #2
    Location
    Everett, WA
    Posts
    886
    Default
    I seem to remember this happening to us back when we were billing for botox and we would separate it actually out into three separate lines with an explanation on line 19 of the HCFA form. Most likely the reason they denied as dupe was because you billed two separate lines with 100 units each, correct? Did you call MCR? My thinking may be outdated here, but try 3 lines, that way your amts will be different and hopefully not deny as a dupe. Just a thought.....maybe others will jump in with another solution...
    Suzanne E. Byrum CPC
    Noridian
    NGS

  3. #3
    Location
    Denver Colorado
    Posts
    287
    Default
    The HCPCS code for Botox is J0585 Injection, onabotulinumtoxinA, 1 unit. The J0588 code is for Xeomin or Injection, incobotulinumtoxinA, 1 unit.

    Both are botulinum toxins but they are not the same drug so you may want to check before you resubmit the claim.

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