decisionhealth Newsletters, Answer Books - 2010 Issue 9 (September)
Drugs / Drug waste doesn't have to be a billing waste
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Article Overview
This article covers Medicare billing guidance for drug wastage and the related CMS policy updates affecting how discarded medication is reported. It is aimed at coders, billing staff, and practices that administer injectable or other billable drugs and need to understand general Medicare guidance, contractor discretion, and documentation considerations.
Why This Topic Matters
Drug wastage can affect claim accuracy and payment when drugs are prepared in single-use or short-shelf-life doses. Understanding the general Medicare framework and local contractor policy helps practices reduce billing errors and avoid inappropriate reporting.
What You Will Learn
- How Medicare addresses reporting of discarded drug amounts
- Why local contractor policies can affect drug wastage reporting
- What general factors influence whether wasted medication is reported
- What types of drug packaging and acquisition methods are discussed in relation to wastage
- Where to look for the broader Medicare policy framework on drug wastage
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Infusion and injection clinic staff
- Compliance teams
Codes Discussed
Modifiers Discussed
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