Hello. I am new to billing for chemo. I am trying to bill Famotidine 20 mg to Medicare w/ CPT S0028, however, they do not recognize this CPT. Is there another CPT that I can bill to Medicare for Famotidine(I was thinking maybe J3490)?? Please help!
We bill J3490, add Famotidine, 20 mgs. & the NDC # in the bililng comments - these are usually paid when billed this way.
There is no way around the S code -- you should be getting an ABN signed... billing J3490 is unethical.
The S codes are used by the Blue Cross/Blue Shield Association (BCBSA) and the Health Insurance Association of America (HIAA) to report drugs, services, and supplies for which there are no national codes but for which codes are needed by the private sector to implement policies, programs, or claims processing. They are for the purpose of meeting the particular needs of the private sector. These codes are also used by the Medicaid program, but they are not payable by Medicare.