July 10, 2015
Billing Update for Zoledronic Acid – J3489
CGS has been made aware of a potential program vulnerability based on the coding and billing of zoledronic acid. Prior to 2014, coding was in place for zoledronic acid marketed under the brand names Zometa® (J3487) and Reclast® (J3488). Effective in 2014, the HCPCS code J3489 was developed and is now used to reflect both drugs which have different dosages and administration frequency.
***Beginning with service date September 1, 2015: When administering Reclast® CGS will require the KX modifier to be appended to the claim submissions.***