decisionhealth Newsletters, Coder Pink Sheets - 2016 Issue 6 (June)
Medicare tightens drug wastage coding rules
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Article Overview
This Medicare billing article summarizes a CMS transmittal that updates how providers report discarded portions of drugs and biologicals on Part B claims. It is intended for billing staff, coders, and compliance teams who handle medication wastage documentation and contractor review requirements. The article also notes the policy context, the effective date, and the types of records contractors may request.
Why This Topic Matters
Providers that bill Medicare Part B for drugs and biologicals need to understand the updated reporting and documentation expectations to support accurate claims and avoid denials or follow-up requests.
What You Will Learn
- How CMS updated reporting for discarded drug amounts on Medicare claims
- What types of documentation may be requested for discarded drug claims
- Which claim-processing context is affected by the update
- How the change fits within broader contractor reporting practices
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Compliance teams
- Medicare providers
Codes Discussed
Modifiers Discussed
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