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Wiki Billing Xeloda to DME

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LBROWN007

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We are having an issue with billing Xeloda to the DME carrier. Does anyone have any advice?
 
Xeloda is an oral medication so I guess I'm wondering why you're billing it to a DMERC carrier? It should be billed under the patient's pharmacy benefits, in case of Medicare that would be Part D. Hope this helps...
 
jbrandt said:
Xeloda is an oral medication so I guess I'm wondering why you're billing it to a DMERC carrier? It should be billed under the patient's pharmacy benefits, in case of Medicare that would be Part D. Hope this helps...
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The Medicare oral anticancer drug benefit is administered by the DME contractors, so for this particular product they are the correct payer.
 
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