Requirements for Billing A/B MAC (A) for Immunosuppressive

80.3.1 - Requirements for Billing A/B MAC (A) for Immunosuppressive Drugs (Rev. 3085, Issued: 10-03-14, Effective: ICD-10: Upon Implementation of ICD-10; ASC X12: January 1, 2012, Implementation: ICD-10: Upon Implementation of ICD- 10; ASC X12: November 4, 2014) Hospitals not subject to OPPS bill on ASC X12 837 institutional claim format or paper Form CMS-1450 (if approved) with bill type 12x (hospital inpatient Part B) or l3x (hospital outpatient) as appropriate. For claims with dates of service prior to April 1, 2000, providers report the following entries: • Occurrence code 36 and date; • Revenue code 0250; and • Narrative description. NOTE: Information regarding the claim form locators that correspond with these fields is found in Chapter 25. For claims with dates of service on or after April 1, 2000, hospitals report: • Occurrence code 36 and date; • Revenue code 0636; • HCPCS code of the immunosuppressive drug; and • Number of units (the number of units billed must accurately reflect the definition of one unit of service in each code narrative. E.g.,: If fifty 10-mg. Prednisone tablets are dispensed, the hospital bills J7506, 100 units (1 unit of J7506 = 5 mg.). NOTE: Information regarding the claim form locators that correspond with these fields is found in Chapter 25. The hospital completes the remaining items in accordance with regular billing instructions.