decisionhealth Newsletters, Answer Books - 2008 Issue 12 (December)
Physician_Fee_Schedule_Rules / 151-160
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Article Overview
This article covers Medicare physician fee schedule policy for drugs and drug administration services, with emphasis on 2005 payment updates, interim coding changes, and the transition from existing CPT drug administration codes to temporary HCPCS G-codes. It is relevant to physicians, coders, billing staff, oncology and infusion practices, and others affected by Medicare drug administration reimbursement and reporting changes. The discussion includes general payment methodology, coding alignment, and administrative updates tied to the Medicare Modernization Act and related review processes.
Why This Topic Matters
It helps readers understand which Medicare coding and payment updates are being addressed for drug administration services and how the 2005 interim transition is structured at a policy level.
Article Sections
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Drug payment methodology and ESRD-related payment policy
Discusses Medicare payment methodology for certain drugs and related payment policy considerations for ESRD facilities. Includes broader market-basket and acquisition-cost themes tied to drug payment updates.
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Drug administration payment policy and coding effective in 2005
Covers the Medicare review of drug administration coding, the transition to interim HCPCS G-codes, and the relationship between existing CPT coding and the upcoming code set changes.
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Table 8: Comparison of old CPT codes to G codes
Provides an organized comparison of legacy CPT drug administration codes with the interim HCPCS G-codes used for 2005 implementation.
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Coding guidance for hydration, infusions, injections, and chemotherapy administration
Summarizes the broad categories of drug administration services addressed by the interim coding guidance and how the article frames the new temporary reporting structure.
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Comment-and-response discussion on payment and coding issues
Reviews stakeholder comments and the agency responses regarding drug administration payment changes, code status, and related billing administration topics.
What You Will Learn
- The general Medicare policy background for drug and drug administration payment updates
- How the article frames the transition from existing CPT drug administration codes to interim HCPCS G-codes
- Which broad service categories are covered by the drug administration coding update
- How the article discusses stakeholder comments and agency responses on payment and coding changes
- The kinds of Medicare payment and reporting issues affecting infusion and oncology-related services
Who Should Read This
- Physician office coders
- Medical billing staff
- Oncology and infusion center administrators
- Compliance teams
- Medicare reimbursement specialists
- Healthcare revenue cycle professionals
Codes Discussed
Code Ranges Discussed
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