Question:

How are no-cost drugs indicated for infusion services when following payer protocols?

Answer:

No-cost drugs are indicated by separate charge lines in accordance with payer instructions. It is becoming more common for the manufacturer, payer, or patient to cover the cost of a drug that will be supplied by a specialty or retail pharmacy—and—for that “no-cost” drug to be delivered to the hospital or clinic for administration. It is important that all documentation components are entered into the record including drug, dose, and NDC for the drug administered. The electronic record will require the entry of information or marking of a checkbox to indicate that the drug is no-cost. This will allow for all documentation to be entered and the base cost to be set to $0.00 or $0.01, therefore no charge will be submitted to the payer.

This question was answered in our Coding Essentials for Infusion & Injection Therapy Services. For more hot topics relating to infusion services, please visit our store or call us at 1.800.252.1578, ext. 2.

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