Wiki Code J0178 Eylea Medicare

[c_selinsky]

Our office has a patient that is on Medicare and requires an injection of Eylea to the right eye about every two week, we have been billing full charges every other visit and a zero dollars on the opposite dates of service. Has anyone else ran into this situation before? Will Medicare do a peer to peer review on this. The goal is to be able to bill for this evert time the patient has the injection done.

Thank you

 

[kmdnine]

I've run into these. We billed for every visit, but modifier GZ was addended to them. In our case, there was never an ABN issued to the patient. There will be no peer to peer review on it.