Question:

What is the outpatient PPS packaging threshold for this year?

Question:

Do you know whether CMS has announced any new pass-through codes for the next quarter?

Question:

Will Medicare pay for an injection if that’s the only reason for an office visit?

Question:

Are hemophilia clotting factors included in the IPPS rates for hospital inpatients?

Question:

What modifiers are required for claims submitted for ESAs administered to non-ESRD patients (J0881 and J0885)?

Question:

Do Medicare payments associated with drug services include payment of the drug and injection of the drug?

Question:

Will Medicare cover IVIG provided in a Medicare beneficiary’s home?

Question:

According to the American Medical Association (AMA), the following code took effect on January 1, 2017: 90682—influenza virus vaccine, quadrivalent (RIV4), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use. However, our MAC has denied claims for this code. Does Medicare not accept this new code?

Question:

How does CMS determine payment for a drug that is not listed in the ASP file?

Question:

Can hospitals bill for a new drug approved by the FDA but with no code assigned yet by CMS?