Q&A: How do we report alemtuzumab?
APCs Insider, August 14, 2015
Want to receive articles like this one in your inbox? Subscribe to APCs Insider!
Q: Our physicians want to administer a drug that’s new to us called alemtuzumab, with the brand name Lemtrada®. However, we found no information concerning a HCPCS code for reporting this drug. How can we bill Medicare?
A: Alemtuzumab is approved by the FDA for the treatment of relapsing forms of multiple sclerosis. CMS created a new HCPCS level II code for reporting this biological. Q9979 (injection, alemtuzumab, 1 mg) will be a valid HCPCS code for Medicare effective October 1.
Providers will want to be sure that their charge structures are set up to report the appropriate number of units to reflect the amount of the drug administered based on the "per 1 mg" description.
In addition, if alemtuzumab is provided in a single use vial, providers must document in the patient’s medical record any amount of drug that is wasted to support the additional units reported on the claim.
For more information, see Transmittal 3304.
Editor’s note: Denise Williams, RN, CPC-H, seniorvice president of revenue integrity services at Health Revenue Assurance Associates, Inc., in Fort Lauderdale, Florida, answered this question.
Want to receive articles like this one in your inbox? Subscribe to APCs Insider!
Related Products
Most Popular
- Articles
-
- Don't forget the three checks in medication administration
- Note similarities and differences between HCPCS, CPT® codes
- Q&A: Primary, principal, and secondary diagnoses
- Differentiate between types of wound debridement
- CDC alert: Screen for international travel as Ebola cases increase
- OB services: Coding inside and outside of the package
- Complications from immobility by body system
- Nursing responsibilities for managing pain
- The consequences of an incomplete medical record
- Practice the six rights of medication administration
- E-mailed
-
- CDC alert: Screen for international travel as Ebola cases increase
- Capturing start and stop times for infusions
- Differentiate between types of wound debridement
- Life Safety Code Q&A: Ambulatory care soiled utility room
- Leadership training for charge nurses
- Helping Charge Nurses understand their leadership role (Part 2 of 3)
- Five ways to safeguard your patients' valuables
- Developing a Fall-Prevention Program
- Coding, billing, and documentation tips for teaching physicians, interns, residents, and students
- Coding tip: Watch for different codes for SI joint injections
- Searched