Question:

What are the correct codes to bill for Reclast and Zometa?

Answer:

In 2014, the Centers for Medicare & Medicaid Services released HCPCS level II code J3489 (injection, zoledronic acid, 1 mg), which can be used to bill for either drug. Note, however that some payers require use of a modifier to identify when the code is being billed for Reclast, and the modifier will bypass the medically unlikely edits (MUE) or allowable unit limit when it is set to 4.

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