It seems like the line item detail for medical billing just goes on and on. FA0 went on for all of 66 fields. If that wasn't enough, now we have the FB0 record which, while it isn't nearly as long, still adds more billable information to this already bloated claim file. In this installment we pick up with field number 15.
FB0 field 15, positions 110 - 120, is the national drug code. Books can be written about drugs in the United Stats in regard to billing. For the sake of brevity and your sanity, we'll keep this as short as possible. Just like each procedure is given a code, called and ICD code, drugs also have codes as well. Each generic drug has a code. Brand name drugs go by the generic code associated with that drug. In other words, there is no drug code for Viagra. The generic form of the drug is used to identify it. If this claim involves billing for a procedure or treatment where a drug was given and the drug is covered under insurance, the drug code must be transmitted in this field.
FB0 field 16, positions 121 - 127, is the national drug units. This is the number of units that were prescribed for this particular drug. If it was a one time administration of a drug for a procedure, then those are the units reported. If it is a prescription for a drug that will be taken over time, then that is how many units to be reported. If both need to be billed, they need to be billed in separate claims, one for the prescription and one for the procedure.
FB0 field 17, positions 128 - 142, is the prescription number. This is the actual prescription number of the drug itself. This is useful information, especially when the drug has to be refilled. This way, the prescription number can just be looked up without having to write a brand new prescription. In most cases multiple refills will be prescribed.
FB0 field 18, positions 143 - 150, is the prescription date. This is the date that the prescription was filled. It will either be in yyyymmdd or mmddyyyy format depending on the specifications of the payer. It is important to note that this is the original prescription date and not the refill date if it is a refill. The reason for this is that most medications must have doctor approval to be refilled after about six months. In some cases, it can be as long as a year.
FB0 field 19, positions 151 - 152, is the prescription number of months. As was stated in the previous description, each prescription is prescribed for a fixed period of time. This field must transmit the number of months, from 1 to 12, that the prescription is written for. The payer will look at the original prescription date. If the current date is past the number of months from the original date then in most cases the claim will be denied. That's why it is critical that drug claims be billed early.
In our next installment of medical billing, we'll pick up with field number 20.
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