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  • Posting Date: 03/26/2024
    Discarded Drugs/Wastage and JW, JZ Modifier

    Discarded Drugs/Wastage and JW, JZ Modifier Medicare may pay for discarded drugs or wasted drugs and biologicals when: The provider/supplier must discard the remainder of a single-dose container after administering a dose or quantity to a [...]

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  • Posting Date: 03/26/2024
    Chemotherapy General Infusion Information

    Chemotherapy General Infusion Information There are CPT codes for several different types of infusions and injections for drugs and biologicals. These include codes for chemotherapy infusions and injections, therapeutic, prophylactic and [...]

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  • Posting Date: 03/19/2024
    Credit Balance Reminder: Submissions For Quarter Ending 3/31/2024 Start Soon!

    Credit Balance Reminder: Submissions For Quarter Ending 3/31/2024 Start Soon! CBR submissions can be submitted starting on 4/1/2024 and are due within 30 days to be considered timely. Remember, even if no monies are owed to Medicare for this [...]

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  • Posting Date: 03/26/2024
    Unlisted Codes for Drugs and Biologicals (J3490, J3590 and J9999)

    Unlisted Codes for Drugs and Biologicals (J3490, J3590 and J9999) An unlisted code should only be used when no other code adequately describes the service. They are commonly used when the drug/biological does not have a specific HCPCS code, [...]

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  • Posting Date: 03/26/2024
    Compound Drugs

    Compound Drugs If there is not a HCPCS code for the compound drug you are billing, then it is appropriate to bill J7999 ‒ Compounded Drug, Not Otherwise Classified. This applies to both pump and nonpump compound drugs. The name, dose and [...]

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  • Posting Date: 03/26/2024
    Prolonged Drug and Biological Infusions Using an External Pump

    Prolonged Drug and Biological Infusions Using an External Pump In some situations, a hospital outpatient department or physician office may purchase a drug for a medically reasonable and necessary prolonged drug infusion, begin the drug [...]

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  • Posting Date: 03/21/2024
    [REVISED] Submitting Paper Claim Forms to National Government Services Due to the Change Healthcare Security Incident

    [REVISED] Submitting Paper Claim Forms to National Government Services Due to the Change Healthcare Security Incident As a follow up to our 2/28/2024 article, Change Healthcare Security Incident, providers have asked if they can submit their [...]

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  • Posting Date: 01/26/2022
    Coding for Sinuva™ Claims

    Coding for Sinuva™ Claims This notice is a coding instruction, and not an indication of coverage. FDA labels should be consulted for indications and usage. Coding updated effective 4/1/2021: Claims submitted to National Government Services [...]

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