Nancy Posted Wed 06th of April, 2011 15:57:19 PM
Could someone please tell me the appropriate way to bill Medicare for a drug that has been brought in by the patient. My provider has only been billing the administration code 96401 and not the drug because the patient brought it in and now Medicare is requesting the $$ back for these dates of services. Please help. Thank You
SuperCoder Answered Thu 07th of April, 2011 17:08:56 PM
Medicare is right in what it said, and you need to refund it.
If you want to avoid the scenario of refund while coding in future practices, you can code both for the drug and also cpt 96401, because you can't bill 94601 without the drug. But, while billing, change the fee value for the drug to "zero" if this is possible in your billing software.
Add a note if allowable in your software regarding the reason to keep the drug value to "0".