Health Information Management

Q&A: Rejections for compounded drug combinations

APCs Insider, October 2, 2015

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Q: We have been receiving rejections on claims including a line item for a compounded drug. We have applied modifier –JF (compounded drug) appropriately and the HCPCS code and units are correct. We can’t figure out what has been happening.
 
A: Modifier –JF was used until June 30, 2015. In the July update to OPPS, CMS retired this modifier and replaced it with HCPCS Level II code Q9977 (compounded drug, not otherwise classified), which became effective July 1, 2015. This HCPCS code should be used to report compounded drug combinations. 
 
Editor’s note: Denise Williams, RN, CPC-H, seniorvice president of revenue integrity services at Revant Solutions, in Fort Lauderdale, Florida, answered this question.



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