How to Respond to Additional Development Requests for Herceptin Billing

Several providers are responding to Herceptin-related ADRs without providing the required information. Herceptin billing must contain the number of milligrams that were used and the number of milligrams that were wasted. In the cases that have been identified, providers have failed to complete the form and have sent in medical records instead. Please complete the blanks on the form for the number of milligrams administered and number of milligrams wasted. Do not send medical records for these claims. You may enter this information on the original claim submission in Item 19, or in the 2300/2400 loop for electronic claims to prevent a development letter from being sent.