vpriya@scioms.com
Contributor
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
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