Wiki Non Covered Injection Drugs

[Melissa Harris CPC]

I need some clarification on something that has come up on our office. If the physician orders an injection in the hip and the drug is non covered by the insurance company, can we have the patient pay out of pocket for the drug and bill the insurance carrier for the hip injection? Or should the patient pay for the entire procedure out of pocket after singing an ABN?

 

[kivbar16]

Bill all of it to the payer. Often they will cover the injection but not the drug. Then what is not covered (not what written off as contractual) is billed to the patient as long as you have an ABN.