Drug and Biological Injections & Infusions: Use of the Quantity Billed Field (QB)
With regard to drug and biological injections and infusions, the quantity billed (QB) field accepts up to four digits. When used, however, the fourth digit represents tenths. Therefore, '100' would be interpreted as one hundred, and '1009' would be interpreted as '100.9'.
Furthermore, to record tenths related to values between 0 and 100, you must provide the leading zeros. Therefore, 0.1 would be '0001' (not '01', which would be interpreted as '1') and 90.9 would be '0909' (not '909', which would be interpreted as nine hundred and nine).
If a single injection is administered with a quantity billed up to 999.9 (coded '9999'), the service must be submitted on one detail line.
If multiple injections of the same drug/infusion are injected on the same date of service, for the same beneficiary and by the same provider, the total dosage injected for the entire date of service up to 999.9 must be submitted on one detail line.
If the dosage(s)/service(s) are submitted on separate detail lines and the dosage is 999.9 or less, the first service will be paid and additional services may be denied as duplicates.
If the total dosage(s) exceeds 999.9, use the fewest possible multiple lines (see the example below) to report the correct quantity.
If a service is submitted with an incorrect QB and has been paid, the corrected claim must be submitted as a review-reopening request and not as a new claim.
Example:
3000 mgs of HCPCS code J9263 (for which the billing unit is 1 mg) were administered to John Q. in the office on December 1, 2008.
Incorrect Example:
| Date of Service | Place of Service | HCPCS Code | QB |
| 120108 |
11 |
J9263 |
3000 (3000) |
This would be interpreted as 300.0 mg. and not the desired 3000 mg.
Correct Example - Submit As:
| Date of Service | Place of Service | HCPCS Code | QB |
| 120108 |
11 |
J9263 |
9999 (meaning 999.9) |
| 120108 |
11 |
J9263 |
9999 |
| 120108 |
11 |
J9263 |
9999 |
| 120108 |
11 |
J9263 |
000.3 (0.3) |
Remember that you are reporting units of a drug as defined by CMS ASP drug files, and these units may not always be 1 mg. Therefore, using the 3000 mg example, if the billing unit for the drug or biological in question was 100 mg, 3000 mg would be reported as '30' units (30 units of 100 mg each) and reported on only one line.
When claims are submitted for HCPCS codes J9999 (not otherwise classified anti-neoplastic drugs), J3490 (unclassified drugs) and J3590 (unclassified biological drugs), the drug name, the National Drug Code (NDC) number and total dosage must be indicated in the appropriate electronic documentation field or the narrative field of the CMS-1500 claim form. The correct number of units for submitting a not otherwise classified (NOC) code is always '1'. The reimbursement will be based on the dosage indicated in the narrative field.