Pharmacy Question for the Week of November 19, 2018

Pharmacy Compliance Question of the Week

Question:

Do we use HCPCS code J0285 when billing amphotericin for irrigation?

Answer:

When a drug or fluid is used for a procedure for the purposes of irrigation rather than for injection or infusion, the hospital may elect to bill the drug or fluid with only an applicable revenue code (e.g., 250).

Although not applicable for your scenario, note that the Centers for Medicare & Medicaid Services’ 2018 Table of Drugs indicates that when amphotericin is administered intravenously, you may encounter a billing edit for code J0285. For the Table of Drugs, go to https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets/Downloads/2018-Table-of-Drugs.pdf.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.