In Billing
Jun 13th, 2017
The July 2017 Average Sales Price (ASP) and Not Otherwise Classified (NOC) drug pricing files and crosswalks are now available on the Centers for Medicare & Medicaid Services’ 2017 ASP Drug Pricing Files webpage. Payment Amounts These files contain the payment amounts that will be used to pay for Part B covered drugs for the third quarter ...
Aug 31st, 2015
The Centers for Medicare & Medicaid Services (CMS) recently announced the annual clotting factor furnishing fee for 2016. At approximately the same time, Palmetto GBA published an article reminding providers how to submit the correct number of units for hemophilia clotting factors. Clotting Factor Furnishing Fee The annual clotting factor furnishing is $0.202 per unit, effective ...
Nov 1st, 2014
Billing relies on documentation to reflect time, resources, and complexity of services accurately. by Janice G. Jacobs, CPA, CPC, CPCO, CCS, ROCC Oncology practices are continually challenged to gain appropriate reimbursement for services performed, resources used, and drugs dispensed. Let’s address potential billing, coding, and documentation problems where lack of understanding can adversely aff...
In Billing
Aug 6th, 2014
You can improve the turnaround time it takes to get claims paid by avoiding this common billing taboo: Don’t report the same procedure code on multiple lines to account for units of service. There’s a more efficient billing method that will help your correctly coded claims sail through adjudication. The keys to success are Medically Unlikely Units (MUE) and modifiers. MUEs ...
In Billing
Aug 2nd, 2013
Physicians sometimes must discard an unused portion of a drug. If the physician (rather than the patient and/or facility) supplies the drug, Medicare may allow compensation for this “wasted” portion. As instructed by the National Medicare guidelines for reporting drug waste found in the Claims Processing Manual, chapter 17, § 40.0, drug waste is reported ...