• 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?

    Answer:
    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.