When billing certain clinician-administered drugs with HCPCS on a p…

Question

When billing certain clinician-administered drugs with HCPCS on a professional claim, what additional drug-identification concept should the coder be aware of?

Accepted Answer

That many payers require NDC information and correct HCPCS units in addition to the HCPCS drug code — A HCPCS drug code is not the whole grocery label. Lots of payers also want the NDC and honest units for the dose given—diagnosis pointers and ‘just bill one unit’ shortcuts do not replace that.

Answer

That diagnosis pointers replace any need for drug identifiers on all payers

Answer

That NDCs are used only on dental claims and never on physician drug lines

Answer

That units are always reported as ‘1’ regardless of dose administered

When billing certain clinician-administered drugs with HCPCS on a professional claim, what additional drug-identification concept should the coder be aware of?

Short Explanation

Full Explanation