Multiple NDC# Billing

vpriya@scioms.com

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Hi all,

I've a question on biling multiple NDC# for same drug Irinotecan (J9206) on same Patient :

Irinotecan 100mg 20mg/ml 5ml SDV - NDC 059923-715-05 - Amount Dispensed -300mg - 15 units
Irinotecan 40mg 20mg/ml 2ml SDV - NDC 61703-0349-16 - Amount Dispensed - 40mg - 2 units

We have billed both vials of same drug in single line item and few carriers are paying partially and denying partial units as NDC dosage doesn't support the code billed. Kindly let me know if there is any modifier to be reported for each line item separately.

Also, please provide me if we can report KO, KP and KQ modifiers for above HCPCS code as few website says it is DME modifiers. I would also appreciate if someone can clarify the difference between KP and KQ modifier.

KP — FIRST DRUG OF A MULTIPLE DRUG UNIT DOSE FORMULATION
KQ — SECOND OR SUBSEQUENT DRUG OF A MULTIPLE DRUG UNIT DOSE FORMULATION

Is the "subsequent drug" refers to different drug or same drug of another NDC. Please clarify.

Any help would be appreciated.

Thanks in advance,
Priya
 

SharonCollachi

True Blue
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Clovis, CA
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Okay, so you're using 3 vials of the 100mg and 1 vial of the 40mg and billing it all on one line? If you're going to use two different formulations that have 2 different NDC numbers, you have to bill them on two separate lines.

However, I would suggest using 3 1/2 vials of 100mg and wastage the other 1/2 vial. At least that would be more clear.

The modifiers you mentioned would not be used for this drug. They are used, for example, when you combine two different drugs in a nebulizer.
 
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