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Thread: Medicare billing ?

  1. #1

    Default Medicare billing ?

    AAPC: Back to School
    If a doctor buys a drug (buy and bill method), the doctor administered the drug in an outpatient setting due to special circumstances. Medicare paid the administration code but denied the drug. the drug was bill along with the administration code with a place of service of the outpatient facility. Does the drug need to be billed separetly with the pos of 11?

  2. #2


    What was Medicare's reason for denying your drug? We always bill our drugs along with the admin, all POS 11. There are issues though when the patient is in a SNF.

  3. #3
    Join Date
    Apr 2007
    North Carolina


    If this service was performed in POS 22, typically, the hospital would dispense the medication and the hospital would bill for the medication. You would have to bill the hospital to regain the cost of the supply (if you have those type of arrangements). If you brought the supply from your office (POS 11) and provided the service in an outpatient setting (POS 22) and then CHANGED the POS to 11 to receive reimbursement...this is setting you up for a whole bunch of problems....

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