Pharmacy Question for the Week of July 17, 2017

Pharmacy Compliance Question of the Week

Question:

Does Medicare require hospitals to report codes for packaged drugs?

Answer:

Although hospitals are not required to report the HCPCS codes for packaged drugs, it is essential that they bill charges for packaged drugs by including them in the charge for the procedure or service for which the drug is used or as a separate drug charge. This is critical because the costs of the packaged drugs are used for calculating the hospital’s outlier and transitional corridor payments. They are also used in the annual update of outpatient APC payment rates for the procedures and services with which the drugs are furnished.

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.