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billing for admin when drug from retail pharmacy

  1. #1
    Default billing for admin when drug from retail pharmacy
    Medical Coding Books
    If we receive medications thru a retail pharmacy (pharmacy in our office) can we bill for the administration of the medication. Some carriers require certain medication to come from a pharmacy and not billed through the office. In this case can we bill for the administration of the drug. The drug is shipped to our in house pharmacy and the patient does not bring it in. Also, we have the same scenario with carrier Kentucky Medicaid, some of the chemo and non chemo drugs have to be purchased through a pharmacy from Kentucky and shipped to our office. In both scenarios we do not bill for the drug but we are billing for the administration. I just want to verify this is correct. None of the drugs are brought to the office by the patient and we do not bill if the patient self administers.

    I hope I explained this ok....... Thanks for any help!!!!!!!
    Dee, CPC
    Tn Cancer Specialists
    Knoxville, TN

  2. #2
    Charleston, South Carolina
    You might check with your specific carriers, they can vary. Medicaid in my state has supplied the medications/vaccines and let you charge an admin charge along with an E/M. We also had patients bring in vaccine and we would charge an admin charge, as they had pharmacy coverage for the vaccine, but not vaccine coverage in the office (and some carriers did not reimburse anywhere near the cost of the vaccine).
    Machelle Morningstar, CPC, COC, CEMC, COSC
    AHIMA Approved ICD-10-CM/PCS Trainer

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