Billing for packaged drugs: Meet coverage requirements
APC Payment Insider, May 1, 2008
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Don’t bill Medicare for noncovered drugs; report with revenue code 0636
If a drug is listed in OPPS Addendum B with a status indicator N (i.e., packaged), should a hospital bill the drug to Medicare?
Not necessarily, says Hugh Aaron, MHA, JD, CPC, CPC-H, senior advisor at HCPro, Inc., in Marblehead, MA. The fact that a drug is listed as packaged in Addendum B does not necessarily mean that Medicare covers it. Rather, a status indicator of N simply means that the drug is packaged for payment purposes if the local Medicare contractor (i.e., an FI or Medicare adminis-trative contractor [MAC]) treats the drug as covered.
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