rheaton
New
Is there anyone that has had a patient have a reaction to a biologic and had to stop the infusion? We billed the J1745 code on two lines like we always do except in this particular situation the waste is the majority of the Remicade due to the reaction. Highmark is denying because we are using the JW modifier (Drug amount discarded/not administered to any patient) on the second line billed for J1745 and they are saying "It is inappropriate for a provider to bill drug wastage that equals or exceeds the size of the vial. We do understand this except in this case due to the reaction we discarded quite a bit of the Remicade. How does anyone else bill reaction. Do we bill without any modifiers?