Wiki Injection modifiers

[gamecocknana]

We have patients that provide their own medication such as Depo or B-12. When the patient comes to the office for the injection we are billing for administering the injection but are getting these codes denied because we are not listing the J Code. Since we are not providing the medication we cannot bill the J Code but have been instructed to use a modifier. Problem is I can seem to find a modifier that would indicate that we administered the injection only. Can anyone help me with this?

 

[beckiw]

How about billing the Depo or the B-12 (as the appropriate J code) with a zero price and modifier -FB?

 

[tfeece]

In the past, when we have had a situation where the patient brought in their own medication for our MA to administer, we would just note that in box 19 (the narrative field) so that the insurance was made aware why there wouldn't be a J code billed. I would just write...Patient brought in their own medication.
I don't recall us ever having any problems with reimbursement of those claims. Good Luck!

 

[asincl01]

Per Medicare and BCBS, you will need to bill the J code and you can add the SL modifier. If you still get a denial or your system will not allow the claim to scrub, bill the medication as (1) cent. I hope this help.

I understand and know the difference between VACCINES and MEDICATIONS. My statement above says "you will need the J code" and you CAN add the SL modifier, not that the modifier was required. There are several different systems out there and depending on which system was purchased, it will require certain modifiers or price changes to satisfy an edit in order for the cliam to file out.