AHA Coding Clinic® for HCPCS - 2005 Issue 3

Coding and payment for drug administration under the hospital outpatient prospective payment system (OPPS)

CMS has made changes to manual instructions for coding and payment for drug administration under the hospital OPPS. These manual instructions can be found in the Medicare Claims Processing Manual, Pub 100-04, Chapter 4, titled “Billing and Payment for Drugs and Biologicals.” Revisions made to these instructions were effective on January 1, 2005 and implemented on June 1, 2005. Following is a summary of this section and its contents. Separately payable drugs In addition to reporting the applicable drug administration codes, hospitals must report all appropriate HCPCS codes and charges for separately payable drugs. Drugs should be...

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