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Modifier needed for injection?

  1. #1
    Default Modifier needed for injection?
    Medical Coding Books

    We have several patients who bring their own medication. Do I need to append a modifier to the administration or to the HCPC code (with a zero amount)?

  2. #2
    Baton Rouge
    You shouldn't need a modifier on the admin code for the injection. We have similar situations for Botox, 1 carrier requires us to order through a specialty pharm instead of using our supply; for those patients we only bill the injection code, and EMG if used. We do enter the J code in our system with "0" charge, but it doesn't go on the claim, it's only for tracking purposes. Same thing when samples are used--we only bill out the injection code.

    Hope that answered your question!
    Meagan Strauss, CPC, CEMC
    Coding Coordinator
    The NeuroMedical Center
    Baton Rouge, LA

  3. #3
    Thanks, that's what I've been doing, but we got a denial that (surprise) made no sense, so I was trying to figure out what they wanted.

  4. #4
    Austin, TX
    Per the Medicare guidelines, you would need to append the KX modifier to the administration for the drug with a zero charge.
    Last edited by cycmkdill; 10-26-2011 at 01:06 PM.

  5. #5
    Baton Rouge
    I wasn't aware of that guideline...this isn't a problem in our clinic, but I did just find an early thread about the KX modifier being required; here's the link:

    and will definitely be researching this more!
    Meagan Strauss, CPC, CEMC
    Coding Coordinator
    The NeuroMedical Center
    Baton Rouge, LA

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