Is a modifier allowed when billing Q9976 for an injection of ferric pyrophosphate citrate solution?


HCPCS level II code J1443 (injection, ferric pyrophosphate citrate solution; 0.1 mg of iron) replaced Q9976 on January 1, 2016. Separate payment for J1443 will be made (with or without the AY modifier) under the end-stage renal disease (ESRD) prospective payment system (PPS). Because the drug identified by J1443 is administered via dialysate, the JE modifier should be assigned to the code, according to the Centers for Medicare & Medicaid Services in MLN Matters Number MM9367. 


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