CMS has clarified the situations in which a pharmacy can bill for dispensing certain drugs, according to an AAPC release.
The situation has been clarified in Transmittal 2312, posted by CMS. Under the guidelines, pharmacies may bill Medicare Part B for certain classes of drugs, including immunosuppressive, oral anti-emetic and oral anti-cancer. They may also bill for drugs self-administered through a piece of durable medical equipment.
Pharmacies and providers cannot bill Part B contractors for drugs dispensed directly to a patient for administration incident to a physician service, such as refilling an implanted drug pump. Pharmacies also cannot bill their DME Medicare administrative contractor for drugs furnished to a Medicare patient, unless the physician purchases the drugs from the pharmacy.
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The situation has been clarified in Transmittal 2312, posted by CMS. Under the guidelines, pharmacies may bill Medicare Part B for certain classes of drugs, including immunosuppressive, oral anti-emetic and oral anti-cancer. They may also bill for drugs self-administered through a piece of durable medical equipment.
Pharmacies and providers cannot bill Part B contractors for drugs dispensed directly to a patient for administration incident to a physician service, such as refilling an implanted drug pump. Pharmacies also cannot bill their DME Medicare administrative contractor for drugs furnished to a Medicare patient, unless the physician purchases the drugs from the pharmacy.
Related Articles on Billing, Coding and Collections:
10 Ways to Get Paid More Per Surgery Center Procedure
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Blue Shield of CA Recommends Use of ASCs Over Hospitals