Reader Question: Self-Administered Drugs

Question: Our hospital wants to clarify what is meant by self-administered drugs (revenue code 253), which are not paid by Medicare. If the patient is provided with a self-administered drug in the outpatient setting, is a signed advanced beneficiary notice form (ABN) required in order to bill the patient? Is there a list of self-administered drugs?

Minnesota Subscriber


Answer: Information about these drugs is generally published in bulletins from local fiscal intermediaries (FIs). Its an area that still confuses payers as well as providers. If the drugs are administered in the emergency department, ABNs are not appropriate. EMTALA considerations take precedent in an ED situation, so issuing an ABN could result in a COBRA violation. ED patients should not be discouraged from seeking care because of financial concerns. An example would be if a patient requires a service but must arrange to pay for it prior to receiving a medical screening examination or emergency treatment in an emergency setting.


- Published on 2001-06-01