Question:
What is the proper way to bill Medicare for no-cost drugs since claims-processing edits prevent drug- administration charges from being billed when the claim does not contain a covered/billable drug charge?
Answer:
The best place to go for this answer is the Medicare Claims Processing Manual, Chapter 32—Billing Requirements for Special Services—section 67.2 at https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c32.pdf. Also, consult transmittal 4013 at
https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2018Downloads/R4013CP.pdf.
CPT® copyright 2024 American Medical Association (AMA). All rights reserved.
Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
CPT is a registered trademark of the American Medical Association.
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