Pharmacy Question for the Week of April 30, 2018

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.

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