Pharmacy Question for the Week of February 19, 2018

Pharmacy Compliance Question of the Week

Question:

When a patient comes in for a cancer chemo injection, can we be paid for the visit too?

Answer:

Medicare contractors will pay separately for cancer chemotherapy injections (CPT® codes 96400–96549) in addition to the visit furnished on the same day. In either case, the drug is separately payable. All injection claims must include the specific name of the drug and dosage. Identification of the drug enables you to pay for the services, according to the Medicare Claims Processing Manual, chapter 17, section 20.5.7.


CPT® is a registered trademark of the American Medical Association.

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.