Monday, April 25, 2011

Reporting of Units for Drugs - correct way

Correct Reporting of Units for Drugs

Ensure that units of drugs administered to patients are accurately reported in terms of the dosage
specified in the full HCPCS code descriptor. That is, units should be reported in multiples of the
units included in the HCPCS descriptor. For example, if the drug’s HCPCS code descriptor
specifies 6 mg, and 6 mg of the drug were administered to the patient, the units billed should be
1. As another example, if the drug’s HCPCS code descriptor specifies 50 mg, but 200 mg of the
drug were administered to the patient, the units billed should be 4. ASCs should not bill the units
based on how the drug is packaged, stored, or stocked. That is, if the HCPCS descriptor for the
drug code specifies 1 mg and a 10 mg vial of the drug was administered to the patient, 10 units
should be reported on the bill, even though only 1 vial was administered. The HCPCS short
descriptors are limited to 28 characters, including spaces, so short descriptors do not always
capture the complete description of the drug. Therefore, before submitting Medicare claims for
drugs and biologicals, it is extremely important to review the complete long descriptors for the
applicable HCPCS codes.


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