Medical Marijuana

saracpm

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Jamaica Estates, New York
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My physician's practice in New York State and just recently completed the requirements to prescribe medical marijuana. I am a little confused as to how to bill this. The patient came in for a consult and has insurance that the doctor participates with, but I am being told that the patient will be self pay because the insurance company will not cover this type of visit (which immediately raises red flags in my mind). The patient has been seen previously for other conditions which have been billed to the insurance company. My understanding was that if we have a contract with the insurance company we can not bill the patient for services provided regardless of whether or not the insurance company will pay for these visits. I am also wondering how this situation would work with a Medicare patient. If anyone has had any experience with this I would really appreciate your help. This is very new to our practice so I am having a hard time finding information as to how to bill this type of a visit.
 

mitchellde

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Columbia, MO
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There is no code to indicate a medical marijuana user. The payer will not cover the cost of the cannabis. However the visit for the condition should still be covered. This is not to be coded as cannabis use or dependence. It is no different than if you were prescribing oxy or Percocet. You do not code those patients as drug dependents either. Just code the condition such as chronic pain.
 

dwaldman

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Medical marijuana (p. 7) This entry states that when marijuana is prescribed by a physician for patient use, code 305.2x, Nondependent abuse of drugs, cannabis abuse, is NOT assigned. Instead, V58.69 (Long-term current use of other medications) should be assigned, given that when marijuana is prescribed by a physician in accordance with state law and taken as directed, it is not considered abuse.
Should an adverse effect occur due to overdosage or because prescribed marijuana was inappropriately administered, an appropriate poisoning code should be assigned. Consider Coding Clinic, 5th Issue 1994, p. 9, for further clarification.

http://www.hcpro.com/content/272221.pdf

AHA Coding Clinic 2nd Quarter 2011
Medical Marijuana

Above talks about AHA Coding Clinic 2011, mentioning using V58.69 for medical marijuana use corresponding to ICD-10 Z79.891 if a code is needed.
 
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