Requirements for Billing A/B MAC (A) for Immunosuppressive Drugs (Rev. 3085, Effective: Upon Implementation of ICD-10)

by  Jared Staheli
July 8th, 2015

Hospitals not subject to OPPS bill on ASC X12 837 institutional format or paper Form CMS-1450 (if approved) with bill type 12x (hospital inpatient Part B) or l3x (hospital outpatient) as appropriate.

For claims with dates of service prior to April 1, 2000, providers report the following entries:

• Occurrence code 36 and date;

• Revenue code 0250; and

• Narrative description.

NOTE: Information regarding the claim form locators that correspond with these fields is found in Chapter 25.

For claims with dates of service on or after April 1, 2000, hospitals report:

• Occurrence code 36 and date;

• Revenue code 0636;

• HCPCS code of the immunosuppressive drug; and

• Number of units (the number of units billed must accurately reflect the definition of one unit of service in each code narrative. E.g.,: If fifty 10-mg. Prednisone tablets are dispensed, the hospital bills J7506, 100 units (1 unit of J7506 = 5 mg.).

NOTE: Information regarding the claim form locators that correspond with these fields is found in Chapter 25.

The hospital completes the remaining items in accordance with regular billing instructions.

References:

Requirements for Billing A/B MAC (A) for Immunosuppressive Drugs (Rev. 3085, Effective: Upon Implementation of ICD-10). (2015, July 8). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/requirements-for-billing-a-b-mac-a-for-immunosuppressive-drugs-rev-3085-effective-upon-implementation-of-icd-10-27122.html

© InnoviHealth Systems Inc

Article Tags  (click on a tag to see related articles)


Publish this Article on your Website, Blog or Newsletter

This article is available for publishing on websites, blogs, and newsletters. The article must be published in its entirety - all links must be active. If you would like to publish this article, please contact us and let us know where you will be publishing it. The easiest way to get the text of the article is to highlight and copy. Or use your browser's "View Source" option to capture the HTML formatted code.

If you would like a specific article written on a medical coding and billing topic, please Contact Us.


contact

innoviHealth Systems, Inc.
62 East 300 North
Spanish Fork, UT 84660
Phone: 801-770-4203 (9-5 Mountain)
Email:
free demo
request yours today
pricing
for any budget
sign IN
welcome back!

Thank you for choosing Find-A-Code, please Sign In to remove ads.