Navigating drug administration codes
Compliance Monitor, February 1, 2006
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It is unlikely that private payers will recognize the new Medicare drug administration HCPCS codes published in the 2006 OPPS final rule, which means that most hospitals across the country will have to use two sets of drug administration (injections/infusions) codes this year, says Jugna Shah, MPH, president of Nimitt Consulting in St. Paul, MN.
If your private payers accepted the now-deleted drug administration Q codes in past years, you might be able to report to all of your payers the combination of the eight new HCPCS C codes and 20 CPT codes as required by Medicare. If so, consider yourself fortunate, Shah says. If you're like most providers and you have to report a combination of C codes and CPT codes to Medicare, but only CPT codes to your private payers, "get ready for a whole host of operational issues," says Shah. This tip is an excerpt from Strategies for Health Care Compliance.
Editor's note: If you have a tip that you would like to share with your compliance peers, please send it to Compliance Monitor Editor Kelly Bilodeau and we'll publish it in a future issue of Compliance Monitor.
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