Question Application of free (pro bono) skin substitutes for Medicare.

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4
Location
Fort Worth, TX
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I work for a wound care clinic that applies free samples given to us by pharmaceutical rep to patients. I wanted to know if there's a way to receive reimbursement from Medicare for the application only. If so, how would I bill this? I attended a seminar that stated that modifier "FB" was required to indicate that we are billing the application for a free product. Once billed the claim is denied stating that we used an invalid modifier.
 
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1
Location
Oakland, California
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Hi there: Actually, modifier FB is intended for Hospital Outpatient Claims subject to the Outpatient Prospective Payment System (OPPS). This modifier should always be used with procedures or devices. The codes that come immediately to mind are those involving Adjacent Tissue Transfers or defect repairs with rotational advancement flaps or better yet, skin grafts. It would be reported on the same line as the procedure. Also, this is not a paid modifier. It is informational and applies to items that are covered without cost to the provider. I hope that helps!
 
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