Health Information Management

Pay-per-view: Defining 'integral' challenging for self-administered drugs

APCs Insider, February 17, 2012

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Self-administered drugs present a significant issue for coders, especially when considering how they may or may not be covered by Medicare Part B. Payers often consider a drug self-administered in some circumstances but not in others. As a result, coders must pay special attention to how these drugs are used within their setting.

"Although it sounds like these drugs should be categorized by the FDA, it's actually your local FI/MAC that makes the determination as to whether a drug is or is not self-administered," said Kimberly Anderwood Hoy, JD, CPC, director of Medicare and compliance for at HCPro, Inc., in Danvers, MA. "They post not only the process used to make the determination, but also a list of drugs that are to be considered self-administered."

Continue reading “Defining ‘integral' tricky for self-administered drugs” on HCPro’s website. Subscribers to Briefings on APCs have free access to this article in the February issue.



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