When a Patient Brings In a Chemo Drug …

Q: Knowing that Medicare requires the claim to reflect the chemotherapy administration code and the corresponding CPT code for the medication administered, how do we bill if my patient purchases the chemotherapy agent and brings the drug in so that the physician can administer it?

A: In this situation, you should:

  • Bill the HCPCS code for the drug administered with the correct quantity (according to the dose per unit specified in HCPCS) and a zero charge.
  • Append the KX modifier to the administration code.

Published April 8, 2011


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June 01, 2016