Tag Archives: hcpcs

Have questions about how drugs are priced? Wondering which pricing methodologies apply to your drug claim? Curious about the origins of the various types of drug codes? Join RJ’s Product and Clinical teams as they walk through the multitude of different combinations of drug claims and pricing methodologies, via clips from the webinar “Shedding Light […]

Many payors have incorporated policies for providers to inform payors on discarded or wastage amounts of drugs in single-use packages. To ensure appropriate reimbursement, the providers are required to submit two claim lines for the administered drug.  One claim line reflects the dosage administered to the patient and the second is for the wastage amount. […]

RJ Health’s Saas provides data regarding the number of billable HCPCS code units that are associated with each NDC. Learn more: VIEW THE FULL WEBINAR   [TRANSCRIPT] Laura: First, we’d like to do a quick orientation to some of the applicable data. We will assume that you have some basic knowledge about medical claims, and we’ll […]

There are several instances where dosing NDC and HCPCS code units don’t agree. Pay special attention when billing for a pediatric dose, that the NDC is billed under the pediatric code if one exists. Each dose has a different NDC unit, and they cross back to the single HCPCS value. If billed under the wrong […]