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(Medicare Part B claims billed with 67028-50 on one line, fees doubled and 1 unit.) HCPCS J-code for medication Appropriate units administered (i.e., EYLEA 2 units) HCPCS J-code on a second line for wasted medication, if appropriate -JW modifier appended Medically necessary ICD-10 code appropriately linked to 67028 and J-Code (s) On the CMS-1500 claim form in item 24a or EDI loop 2410: 11-digit NDC code in 5-4-2 format, proceeded by N4 qualifier followed by unit of measurement (UOM), ML and appropriate amount (eg ML0.05) Example Avastin: N450242006001 ML0.05 19 or EDI equivalent: Description of medication and dosage per insurance guidelines (e.g

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