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

[Andrea828]

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.

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!

 

[dalanicks@aol.com]

67028 50 or if the carrier does not like 50 67028 rt and 67028 lt, and the j code bill it one line 2 units you should be fine

 

[kathy a]

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

 

[JudyBoring]

Billing eye clinic/surgery ctr

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