• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Drug Code billing

Create Wiki
A

Art111085

Guest
Messages
18
Best answers
0
When a drug code is "per mg" (ie- J2250 per 1mg) do I code as 2 units when we use 1.75 mg?
Is there a different way I need to code this?
 
This manual might be helpful in finding out the answer. Here is some info I pulled from it.


https://www.cms.gov/manuals/downloads/clm104c17.pdf


Hospitals must report all appropriate HCPCS codes and charges for separately payable drugs, in addition to reporting the applicable drug administration codes. Hospitals should also report the HCPCS codes and charges for drugs that are packaged into payments for the corresponding drug administration or other separately payable services. Historical hospital cost data may assist with future payment packaging decisions for such drugs. Drugs are billed in multiples of the dosage specified in the HCPCS code long descriptor. If the drug dose used in the care of a patient is not a multiple of the HCPCS code dosage descriptor, the provider rounds to the next highest unit based on the HCPCS long descriptor for the code in order to report the dose provided.
If the full dosage provided is less than the dosage for the HCPCS code descriptor specifying the minimum dosage for the drug, the provider reports one unit of the HCPCS code for the minimum dosage amount.
OPPS Pricer includes a table of drugs and prices and provides
 
You must log in or register to reply here.
Top