Invoice No Longer Required for Some Medicare Claims
By Ellen Terry

Cleaners

For certain biologicals and medications reported in Medicare Part B claims, Novitas Solutions now will allow you to enter invoice information on the claim, rather than provide the actual invoice for the services.

You must enter:

  • Invoice dollar amount; and
  • The dosage of the medication, or the size of the biological administered.

The invoice amount is the amount you paid for the product as shown on the actual invoice; don’t submit retail amounts, extraneous fees, or the amount charged to the patient.

Enter the invoice amount on block 19 of the CMS-1500 paper claim form, or in Loop 2400, Segment NTE02, for electronic claims, in the following format (including cents): Inv $00.00.

Claim example:

19. ADDITIONAL CLAIM INFORMATION (Designated by NUCC)

Inv $1140.00 for PalinGen Membrane 2cm x 3cm 

Currently affected codes are high osmolar contrast material and skin substitute codes (see the full list). Novitas says it will add to the list regularly.

Last Updated On

June 03, 2020

Ellen Terry

Project Manager, Client Services

(512) 370-1391

Ellen Terry has been writing, editing, and managing communication projects at TMA since 2000. She hails from Victoria, Texas; has a journalism degree from Texas State University; and loves to read great fiction. Ellen and her husband have two grown sons and a couple of cats.

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