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Patient Brings Own Meds to Outpatient Dept

  1. Arrow Patient Brings Own Meds to Outpatient Dept
    Medical Coding Books
    We are provider based... which means that we are considered an outpatient deparment of the hospital instead of place of service office. This also means that we cannot charge the same way as office because our charges go on a UB paid from Part B.

    That being said, if a patient brings their own meds, we cannot just charge 96372 on a UB, we MUST provide the drug being administered. The question is, do we use the Jcode with dollar value $.01 or do we charge regular price with an FB modifier on the Jcode or 96372?

  2. #2
    Default Pt Brings Own Meds
    Thought you might want to view this article which I came across for your question.
    Modifier-FB; Item Provided Without Cost to Provider, Supplier or Practitioner (Examples, but not Limited to: Covered Under Warranty, Replaced Due to Defect, Free Samples)
    Effective for services furnished on or after January 1, 2006, hospitals must report HCPCS modifier -FB with the HCPCS code for a device that was furnished to the hospital without cost to the provider.
    For example, when a manufacturer furnishes a replacement device that has been recalled or has failed and that was furnished to the provider without cost to the provider, the hospital must report the modifier -FB with the device code to indicate that the hospital did not incur a cost for the item.
    This requirement applies to all HCPCS alphanumeric device codes with initial letter of “C” or “L.” Hospitals should submit a token charge (e.g., $1.00) on the line with the device code for the claim to be accepted and processed. If the hospital uses a device that was furnished to it for no cost, but for which the usual cost to the hospital is greater than $50.00 and for which there is no suitable HCPCS alphanumeric code beginning with initial letter of “C” or “L,” the hospital must use the modifier -FB with the procedure code for the service in which the device is used.

    pulled from publication from Medicare's site (MLN Matters Number MM4250).

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