18. How are providers to bill the 340B modifiers for drugs administered to dual-eligible beneficiaries? Is the “UD” modifier required for Medicaid?
When Medicare is either the primary or secondary payer, the appropriate 340B modifier is required in accordance with the OPPS 340B payment policy. Because Medicaid billing requirements vary by state, providers should contact the applicable State Medicaid Program for guidance on billing 340B drugs. Normal CMS policy and procedures and trading partner agreement requirements for coordination of benefits (COB) claims will be followed.
Are you wanting to bill both the IV solution and the oral contrast? and is this denying from the payer? Is this the facility or the physician claim.