Health Information Management

Billing for packaged drugs: Meet coverage requirements

Briefings on APCs, April 1, 2008

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 Administrative Contractor [MAC]) treats the drug as covered.

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