Pharmacy Question for the Week of August 28, 2017

Pharmacy Compliance Question of the Week

Question:

If the units of a drug given exceed the size of the units field on the claim, how should the remaining be billed?

Answer:

According to Medicare Claims Processing Manual (chapter 17, section 70), if the units provided exceed the size of the units field, or require more characters to report than spaces available in the format, providers should repeat the HCPCS or national drug code (NDC) on multiple lines until all units can be reported.

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.