Medicare Claims Processing Manual (Pub. 100-04), Ch. 17 § 80.1.3
Other Claims Processing Issues for Oral Cancer Drugs
80.1.3 - Other Claims Processing Issues for Oral Cancer Drugs
(Rev. 1, 10-01-03)
Deductible and coinsurance apply.
A cancer diagnosis code must be reported when billing for these HCPCS codes. If there is no cancer
diagnosis the claims is denied.
The number of tablets or capsules is reported as units.