NOV 14, 2022
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.