AHA Coding Clinic® for HCPCS - 2013 Quarter 3; For Your Information
Correct reporting of Rituximab and Bevacizumab - dosage vs. units
Rituximab and Bevacizumab are both chemotherapeutic drugs. Rituximab is utilized in the treatment of rheumatoid arthritis, Hodgkin’s lymphoma, and chronic lymphocytic leukemia. Bevacizumab is utilized in the treatment of patients with metastatic colorectal cancer. To accurately report the usage of Rituximab and Benvacizumab, billers and coders must verify the milligrams given and if necessary convert to the proper units, and ensure the quantity administered is consistent with the number of units billed. Key points to remember when billing Medicare for Rituximab: J9310 is defined in the HCPCS manual as: Injection, rituximab, 100 mg. One (1) unit represents 100...
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Article Overview
This article is a billing and coding reference for Medicare claims involving two chemotherapy drugs. It is aimed at coders and billers who need to understand general dosage-to-unit reporting concepts, verify administered amounts, and review the related CMS guidance referenced by the article.
Why This Topic Matters
Accurate unit reporting is important for consistent claims submission and for aligning billed quantity with the administered drug amount. The article helps billing staff recognize the broad reporting considerations associated with these medications and where to look for related CMS material.
What You Will Learn
- How the article frames dosage-to-unit reporting for chemotherapy drug claims
- Which Medicare-related billing considerations are highlighted for the medications discussed
- Why administered quantity and billed units need to be aligned in drug reporting
- Where the article points readers for additional CMS guidance
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Oncology billing staff
Codes Discussed
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