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A clean claim submission checklist for J0178 includes: HCPCS code J0178 with the correct number of units (1 mg = 1 unit) CPT code 67028 on the same claim line or as a separate service line Approved ICD-10-CM diagnosis code from the MAC-approved Group 2 list Laterality modifier (-RT or -LT) on both the drug and procedure lines National Drug Code (NDC) with the qualifier N4 and the dispensed quantity Place of service code matching where the injection was performed Prior authorization number in field 23 of the CMS-1500 form when PA is required Common denial reasons for J0178 claims include: missing or mismatched diagnosis code, missing NDC, incorrect unit count, and missing administration code (CPT 67028)
