03/20/2026

[Duplicate] ASK MSHO

March 2026 Frequently Asked Questions

Question

Reading up in the BCBS Billing Chart for any updates that affect us, I found on page 57 and error in the HCPCS Code for Omisirge, which should have been J3590 or C9.99, but was instead listed as J9271 – WHICH IS KEYTRUDA’S HCPCS Code.  I am concerned that this may create a problem for us billing Keytruda due to the restrictions of Omisirge.  Do you know whom to send this error to who can get it corrected with the right department knowing about it so claims are not adversely affected? (Vernell Hester)  (2026 Feb Record Billing Chart.pdf)

Answer

BCBSM agrees there is an error and has sent the request for correction.

Question

Do you have any resources to help practices who are billing for clinical trials?

Answer

NCD for routine costs in clinical trials. 

 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52430&ver=11&contractorName=9&contractorNumber=239%7C1%2C228%7C2%2C240%7C1%2C238%7C2&articleStatus=all&sortBy=title&bc=4.  

Question

Can we bill for a sequential infusion in addition to 96413 when a single bag contains multiple drugs?

Answer

Do not bill for a sequential infusion in addition to 96413 when a single bag contains multiple drugs or substances. The billing of sequential infusion is meant to represent the work unit associated with administering a separate infusate. (Coding Essentials)