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Content provided on this page contains outdated information and instruction and should not be considered current. CGS is providing this archived information for research purposes only. This archived section contains previously issued instructions that have since been updated or are no longer applicable for Medicare billing purposes.

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.***


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