• Does National Government Services Allow Splitting Single-Use Vials of Botox?

    We are seeing more botulinum toxin patients on the same day; there are opportunities to have three patients share a vial and only bill a small amount of wastage. After reviewing single-use coding, multiuse coding and blepharospasm documents as well as the NGS Medicare billing LCD, it is not clear if splitting a vial is allowed by NGS Medicare. Will you share documentation that clarifies this?

    At this time NGS does not have published guidelines for split vials. See the Botox treatment fact sheets at Coding Topics - American Academy of Ophthalmology.

    When there is no published payer policy for split vials, then report one single-use vial and bill appropriate wastage with -JW modifier.

    Review current policies at aao.org/lcds.