Question:

Have the new rates for flu vaccines been issued yet?

Question:

When does Medicare cover self-administered drugs?

Question:

Will Medicare issue payment when the main reason for a patient’s visit is to receive an injection?

Question:

The FDA recently approved a biosimilar called Fulphila. Is there a HCPCS code yet for it?

Question:

For medications used from Canada that have only a DIN and not an NDC, are you aware if there is a generic NDC that can be used or if CMS and other payers ever recognize the DIN on claims?

Question:

If a drug is not listed in the Medicare ASP or NOC file, does that mean it’s not covered?

Question:

We have a Coumadin clinic at our facility. The patients are seen by a Coumadin nurse who does a full assessment on the patient she sees every month. During the assessment she also does a PT/INR check on the patient. Is it appropriate to bill the evaluation and management (E & M) level G0463 and the PT/INR check 85610. We have been struggling with this issue for a while and would like some clarifications as soon as possible.

Question:

I heard that Medicare may increase the drug payment amount for next year. Is this true?

Question:

Where can I find the drugs with corrected Medicare payment rates, and can I resubmit claims to ensure we are paying the correct rate?

Question:

What OPPS billing guidelines should be followed when commercially available products are mixed together to facilitate their concurrent administration?