Oncology & Hematology Coding Alert

Question: If a patient brings her own medication to the office for administration, how should we report this on the claim?

North Carolina Subscriber

Answer: 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.