OCT 13, 2023
Botox Split Vials
Does the introduction of modifier -JZ mean that sharing botulinum toxin vials among multiple patients is no longer allowed, and how does it impact billing practices?
Answer:
Noridian is the only Medicare administrative contractor that has a published policy with guidance for billing split vials and it specifies patients are billed for their pro-rated share of wastage. For commercial payers, Medicare Advantage and Medicaid, you must follow each unique documentation and coding policy, typically found on their physician websites. In the absence of a published policy, report one single-use vial per patient and use the -JW modifier for appropriate wastage, as required since Jan. 1, 2017.
Learn more about reporting wastage in Fundamentals of Ophthalmic Coding and Coding for Injectable Drugs, both referenced in the Savvy Coder article, Meet Modifier –JZ: A Quick Guide to –JW’s New Counterpart