Oncology & Hematology Coding Alert

Question: I’m new to medical coding. I read something about not charging Part B for drugs that are usually self-administered, but how do you know whether a drug falls in that category? Tennessee Subscriber Answer: The list of self-administered drugs (SAD) is determined by each Medicare contractor, so you have to check the list for the particular payer you’re reporting to. To find the list, check the specific payer’s site, or search for that payer’s SAD article on the Medicare Coverage Database (MCD). In some cases, the payer’s site will take you directly to its article on the MCD. Tennessee example: Cahaba’s SAD Exclusion site for Part B is at www.cahabagba.com/part-b/medical-review/self-administered-drug-sad-exclusion-list/. On the site, there’s a SAD List link for J10 MAC B Tennessee. Click the link, and you’ll be taken to an MCD page. Click the link for the article "Self-Administered Drug Exclusion List -- J10 MAC" (A48903). You may [...]