Wiki Avastin, Lucentis codes being billed on both eyes same DOS

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Andrea828

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Happy Holidays everyone!!

I bill for a practice that occasionally injects both eyes on same DOS. I know I can only bill the 67028 once, but when I bill out the medication using RT and LT modifiers only, the insurance companies reject the second eye saying service can't be billed this many times. Should I be using an additional modifier on the second eye? The insurance companies are obviously no help in this department. :D

J9035 RT
J9035 LT

J2778 RT
J2778 LT

These already have multiple units on them. I need to know if I should put a 59, 51, 79, etc on the second J-Code?

Any help would be GREATLY appreciated!
 
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Avastin,Lucentis Codes being billed the on both eyes same DOS

Avastin-We bill it the same way as she does. 50 Mod with a quantity of 2. RT,LT if insurance doesn't like the 50 Mod. The number of units is 5 per eye. 2 eyes 10 units.

Lucentis-the same for the injection.
.3 dose is 3 per eye, 6 units for both eyes.
.5 dose is 5 units per eye, 10 units for both eyes.

Kathy
 
Billing eye clinic/surgery ctr

Why would j2778 not be payable with 67028? Is this payable if billed under a different pos/tos?
 
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