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Anesthesia Coding Alert

Reader Question:

Submit All Drug Details on Claim Form

Published on Sun Nov 11, 2012

Question: We provide injections and infusions in our office and seem to keep getting denials on the HCPCS drug supply charges we are billing out to payers. What might we be doing wrong?Oregon SubscriberAnswer: Without knowing the denial code you are getting back, it is hard to say why you are seeing denials. Here are a few possible reasons, however: When you submit a claim for drug payments, in many cases, it is now necessary to also include the full drug name, the total dosage or units administered, method of administration, and the National Drug Code (NDC) number on the claim form. If you are missing any of that information, you may see rejections for that reason. You may be putting the wrong number of units in box 24G on the CMS-1500 form, or using the wrong administration code to go with the drug you are reporting. Example: Your physician [...]
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