Cpt Drug Codes

Written by Norene Anderson
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CPT drug codes are used for toxoids, vaccines, and immune globulins given in a physician's office or clinic or by a home health agency. This includes drugs for injection under the skin, in the muscle, or in the vein. This specifically recognizes chemotherapy drugs and antiemetic agents. The drug reimbursement code is part of the CPT and HCPCS drug coding system. The pricing information is provided in billable units.

Administering injectables requires the correct filing of the HCPCS J-codes or CPT drug codes for the appropriate reimbursement. The administration charge is not included in this identification number. A separate code for CPT drug administration must be entered to recover these charges. This would be a code such as 90782, 90799, or other appropriate codes. This is allowed if there is not an E&M (evaluation and management) code billed for the same visit.

Use of CPT Drug Codes

The guidelines for CPT drug codes are very strict and straightforward for the allowable charges and the proper way to file these charges. It is worth every penny for a healthcare provider to hire a properly trained expert in diagnosis and drug coding procedures. Documentation must support every charge billed. If there is not a clear record of medication and evaluation activity, the charges may be denied.

The procedure codes for vaccines and toxoids include the fee for administering the medication. There cannot be a separate charge for administration. If it is filed, it is a request to return the fee is most likely. HIPAA has established that the health care industry adopt standard code sets for all electronic transactions. This guarantees that every claim is handled according to the same guidelines.

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