tci Outpatient Facility Coding Alert - 2012 Issue 3

Reader Question: Ensure Claim Form Includes All Infusion Details

Question: Our ASC keeps getting denials for drug supply charges during injections and infusions. Any ideas of what might be the problem? Vermont Subscriber Answer: It’s difficult to pinpoint the reason behind the denials without knowing which denial codes the payers are sending. Consider these common mistakes and whether they might be the root of your problem. When you submit a claim for drug payments, in many cases, it is now necessary to also include the full drug name, the total dosage or units administered, method of administration, and the National Drug Code (NDC) number on the claim...

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