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Oncology & Hematology Coding Alert

Reader Question:

HCPCS Reporting for Patient-Provided Drug Varies

Published on Fri Jun 10, 2011

Question: If a patient brings her own medication to the office for administration, how should we report this on the claim?North Carolina SubscriberAnswer: The correct method of reporting will depend on your payer.For instance: In Palmetto's April 21, 2011, Ask the Contractor Teleconference Q&A, a question from a provider transitioning from Trailblazer explained that the rule they followed under that carrier was to report the J code for the drug with a zero charge. Modifier KX (Requirements specified in the medical policy have been met) was also required for the line item.Palmetto GBA instead instructed its Jurisdiction 11 providers to submit patient-provided drug information (HCPCS code, drug name, and total dosage administered) in the electronic claim's documentation field.You'll find the Q&A online at www.palmettogba.com/palmetto/providers.nsf/ls/Jurisdiction%2011%20Part%20B~8GXLFT8281?opendocument&utm_source=J11BL&utm_campaign=J11BLs&utm_medium=email.
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