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Coding reminders about J-codes for commercial and Medicare providers

06/24/2016

When you bill for medical benefit injectables (J codes) for both our commercial and Medicare lines of business, please remember to bill for both the drugs and the administration or injection procedure of the drugs. 

Here's how to bill for:

  • Bilateral billing
    • J codes for drugs: Bill on one line with no modifiers and the total number of units that was administered.
    • Administration/injection procedure code: Bill on one line with a 50 modifier for 1 unit.
  • Non-bilateral billing
    • J codes for drugs: Bill J code with no modifiers and the appropriate number of units.
    • Administration/injection procedure code: Bill on one line and with the appropriate RT (right), LT (left) modifier.