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
Originally Published On
June 03, 2020