2022 Q4 JM invoices Must Be Submitted for Certain Drug And Biological Codes
2022 Q4 JM invoices Must Be Submitted For Certain Drug And Biological Codes
The Centers for Medicare & Medicaid Services Internet-Only Manual publication 100-04, chapter 17, Drugs and Biologicals 20.1.3, Exceptions to Average Sales Price (ASP) Payment Methodology: gives MACs discretion to use invoice or WAC pricing when CMS does not provide a payment limit on the ASP file.
| The following codes require invoices at this time: | ||||
|---|---|---|---|---|
|
90284 |
90654 |
90655 |
90657 |
90660 |
|
90661 |
90669 |
90749 |
A4290 |
A4360 |
|
A4641 |
A4642 |
A4648 |
A4650 |
A9501 |
|
A9504 |
A9508 |
A9509 |
A9510 |
A9515 |
|
A9516 |
A9517 |
A9524 |
A9527 |
A9529 |
|
A9530 |
A9531 |
A9532 |
A9536 |
A9542 |
|
A9543 |
A9544 |
A9545 |
A9546 |
A9547 |
|
A9548 |
A9550 |
A9551 |
A9553 |
A9554 |
|
A9556 |
A9557 |
A9558 |
A9559 |
A9562 |
|
A9563 |
A9564 |
A9566 |
A9567 |
A9570 |
|
A9571 |
A9572 |
A9580 |
A9582 |
A9597 |
|
A9600 |
A9604 |
A9999 |
C1822 |
J0120 |
|
J0131 |
J0210 |
J0282 |
J0330 |
J0400 |
|
J0604 |
J0606 |
J0833 |
J0884 |
J0945 |
|
J1130 |
J1305 |
J1330 |
J1435 |
J1444 |
|
J1455 |
J1457 |
J1573 |
J1726 |
J1729 |
|
J1738 |
J1741 |
J1790 |
J1890 |
J1990 |
|
J2180 |
J2320 |
J2370 |
J2547 |
J2650 |
|
J2710 |
J2787 |
J2910 |
J2950 |
J3110 |
|
J3303 |
J3310 |
J3400 |
J3470 |
J3472 |
|
J7131 |
J7309 |
J7315 |
J7615 |
J7645 |
|
J9118 |
J9219 |
L7510 |
L8604 |
L8699 |
|
L9900 |
Q0507 |
Q0508 |
Q0509 |
Q2028 |
|
Q2035 |
Q2039 |
Q2049 |
Q3001 |
Q4100 |
|
Q4103 |
Q4105 |
Q4105 |
Q4107 |
Q4108 |
|
Q4113 |
Q4114 |
Q4116 |
Q4117 |
Q4118 |
|
Q4124 |
Q4125 |
Q4126 |
Q4128 |
Q4130 |
|
Q4134 |
Q4135 |
Q4136 |
Q4138 |
Q4140 |
|
Q4142 |
Q4143 |
Q4146 |
Q4147 |
Q4148 |
|
Q4149 |
Q4150 |
Q4152 |
Q4156 |
Q4157 |
|
Q4161 |
Q4164 |
Q4165 |
Q4167 |
Q4175 |
|
Q4179 |
Q4182 |
Q4183 |
Q4184 |
Q4190 |
|
Q4191 |
Q4193 |
Q4198 |
Q4199 |
Q4200 |
|
Q4204 |
Q4209 |
Q4211 |
Q4214 |
Q4216 |
|
Q4220 |
Q4221 |
Q4226 |
Q4228 |
Q4229 |
|
Q4236 |
Q4237 |
Q4238 |
Q4239 |
Q4240 |
|
Q4241 |
Q4242 |
Q4248 |
Q4249 |
Q4250 |
|
Q4255 |
Q9953 |
Q9954 |
Q9962 |
Q9983 |
|
V2785 |
|
|
|
|
Please note that failure to submit an invoice, submitting unclear invoices, or submitting incomplete invoices could result in claim rejections.