Brandy0618
Guru
We received a letter from a carrier reporting that claims are required to be submitted based on (HCPCS) units, not the dosage administered. As I research this I am more confused that when I started. The example in the front of HCPCS explaining that if one ostomy pouch is used it should be reported as a quantity of 10 since the pouch comes in a quantity of 10. This really sounds like fraud to me. The injectable most used in our office is J0561, and J0696. We order these in boxes of 10, however it simply sounds like fraud to report 10 on the quantity box when we only used one vial out of the box, whether it was 1.2 million or 600,000.00. Could anyone help shed some light on this for me? Thank you so much, Brandy Blue-Smith CPC