Ophthalmology and Optometry Coding Alert

Optometry/Ophthalmology Coding:

Don’t Forget the JZ Modifier for Full Drug Administration

Question: An ophthalmologist performed an intravitreal injection of 2 mg of EYLEA on a Medicare patient. How should we report the injection procedure and what code should we use for the EYLEA supply?

South Dakota Subscriber

Answer: You’ll use HCPCS Level II code J0178 (Injection, aflibercept, 1 mg) to report the EYLEA pharmaceutical for the patient and assign CPT® code 67028 (Intravitreal injection of a pharmacologic agent (separate procedure)) for the injection procedure.

Code J0178 carries a 1 mg unit descriptor, which means you’ll need to report 2 units of the code for the 2 mg injection. Also, you’ll append modifier JZ (Zero drug amount discarded/not administered to any patient) to J0178 if no amount of the drug was wasted during the injection procedure.

Mike Shaughnessy, BA, CPC, Production Editor, AAPC