MAY 30, 2023
How to Bill Wastage for Botox and Two Patients
Question: We have two Medicare patients who received medical botox the same day from the same vial. One received 50 units and the other 25, leaving 25 units of wastage. What is the best way to report this?
Answer: Currently Noridian is the only MAC that allows billing split vials for Botox; follow their published LCD guidelines . Also, confirm commercial, Medicare Advantage and Medicaid payer policies and follow their unique documentation and coding guidelines.
If there is no published payer policy regarding split vials, then report one single-use vial per patient and billing appropriate wastage with -JW modifier.
To learn more, visit Coding Topics to download Botox fact sheets.
Learn more about reporting wastage in Fundamentals of Ophthalmic Coding and Coding for Injectable Drugs