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Billing for oral medications

We frequently give an initial dose of Orapred to our asthmatics in our
office. We don't get samples, so we have to buy the Orapred ourselves.
There's no HCPCS or CPT code for the administration of the medication or
for oral medications, so I'm wondering how to bill this. I know ERs and
hospitals bill for oral medications, so what's the right way to do this?

Len L.

Billing for oral medications

At 01:30 PM 5/18/2004, Len Leshin wrote:

>We frequently give an initial dose of Orapred to our asthmatics in our
>office. We don't get samples, so we have to buy the Orapred ourselves.
>There's no HCPCS or CPT code for the administration of the medication or
>for oral medications, so I'm wondering how to bill this. I know ERs and
>hospitals bill for oral medications, so what's the right way to do this?
>
>Len L.

HCPCS codes:

J7506 Prednisone per 5 mg

J7510 Prednisolone per 5 mg

Couldn't find a code for the actual administration itself (and I'm sure an
insurance company would say it's bundled into the E&M code).

I believe (and someone please correct me if I'm wrong) that the "right" way
to bill for the medication is to charge your actual purchase cost (at least
that's what I was told when we began administering Rocephin a long time
ago). Or you can do what ERs and hospitals do and charge $20.00 for 50
cents worth of Orapred!

Michael K. Sachs, M.D.
General Pediatrician

Billing for oral medications

At 02:27 PM 5/18/2004 -0700, Michael Sachs wrote:
>At 01:30 PM 5/18/2004, Len Leshin wrote:
>
>>We frequently give an initial dose of Orapred to our asthmatics in our
>>office. We don't get samples, so we have to buy the Orapred ourselves.
>>There's no HCPCS or CPT code for the administration of the medication or
>>for oral medications, so I'm wondering how to bill this. I know ERs and
>>hospitals bill for oral medications, so what's the right way to do this?
>>
>>Len L.
>
>
>
>HCPCS codes:
>
>J7506 Prednisone per 5 mg
>
>J7510 Prednisolone per 5 mg

But the section heading for the J codes in my HCPCS manual specifically
says for other than oral drugs.

Len L.

Billing for oral medications

> >At 01:30 PM 5/18/2004, Len Leshin wrote:
> >
> >>We frequently give an initial dose of Orapred to our asthmatics in our
> >>office. We don't get samples, so we have to buy the Orapred ourselves.
> >>There's no HCPCS or CPT code for the administration of the medication or
> >>for oral medications, so I'm wondering how to bill this. I know ERs and
> >>hospitals bill for oral medications, so what's the right way to do this?
> >>
> >>Len L.
> >
> >

At 02:27 PM 5/18/2004 -0700, Michael Sachs wrote:

> >
> >HCPCS codes:
> >
> >J7506 Prednisone per 5 mg
> >
> >J7510 Prednisolone per 5 mg
>

At 01:32 PM 5/19/2004, Len Leshin wrote:

>But the section heading for the J codes in my HCPCS manual specifically
>says for other than oral drugs.
>
>Len L.

I got those two codes from Encoder Pro and when I copied them I accidently
left out the word "oral" - which is part of the HCPCS description for each
code. I couldn't find a "section heading" for J codes in Encoder Pro.

Len - what exactly do you mean by '"..specifically says for other than oral
drugs"? What else does the section heading say that might clarify it?

Michael K. Sachs, M.D.
General Pediatrician