Article Detail - JE Part B
ESRD Facilities: Bill Correctly for Cinacalcet Oral Drug
Beginning January 1, 2021, the cinacalcet oral drug is eligible for consideration as an ESRD outlier service:
- Report the number of tablets or pills, not the number of units (for example, milligrams)
- Report revenue code 250 with the national drug code
- Don’t use revenue code 0636 with HCPCS code J0604
More Information:
- MLN Matters Article MM12011 (PDF), page 7
- ESRD PPS Outlier Services webpage
- Medicare Benefit Policy Manual, Chapter 11 (PDF), §20.3.C
- Medicare Claims Processing Manual, Chapter 8 (PDF), §60.2.1.2
Source: CMS MLN Connects dated September 23, 2021
Last Updated Tue, 12 Oct 2021 15:32:14 +0000