- Categorization and explanation of benefit coverage for drugs under the Medicare Part B or Part D Program
- Listing of all related HCPCS (Healthcare Common Procedure Coding System), established by CMS (Centers for Medicare/Medicaid Services) and/or the CPT® (Current Procedural Terminology Codes) established by the AMA (American Medical Association) for billing under the Part B benefit
- Ability to search by:
- Drug or Product name (Brand or Generic) - NDC Number
- View CMS Frequently Asked Questions
- Access CMS downloadable forms for Prior Authorization or Provider-Pharmacist Communication available in the MEDICARE RESOURCES section
- Through the MEDICARE RESOURCES section, link directly to downloadable educational materials for health care professionals specific to Medicare Prescription Drug Coverage
- More accurate claims processing
- Faster reimbursement for drugs or products
- Fewer rejected claims
- Updated drug listing for both generics and brands
- Review current status of NDCs (National Drug Codes), for active vs. inactive status
- CMS resources including downloadable forms and links to the Medicare Prescription Drug Benefits Program sites
The new Medicare Part D prescription drug benefit provides
coverage for some classes of drugs which may, in some
circumstances, be eligible for coverage under Medicare Part B. An
informational table to guide healthcare professionals regarding
appropriate billing for these products is available on this site.
PartBorPartD.com
makes available specific criteria for use in determining when to
bill Part B or Part D for a particular product or drug, in
addition to the corresponding HCPCS (Healthcare Common Procedure
Coding System) and/or CPT® (Current Procedural Terminology) codes
for those drugs or products.
PartBorPartD.com
allows Pharmacists and other Healthcare Professionals to
accurately determine billing for drugs and products under the
Medicare Prescription Drug Benefit Program: Part B or Part D.
The
PartBorPartD.com
website is updated monthly based on receipt of new information
from CMS (Centers for Medicare and Medicaid Services) and research
by RJ Health Systems International, LLC.
CPT® copyright 2010 American Medical Association. All rights reserved. CPT® is a registered
trademark of the American Medical Association
Disclaimer
The
PartBorPartD.com
website is to be used for informational purposes only. No
liability is assumed with respect to accuracy of codes, or data
herein, due to either clerical or typographical error. All
descriptions of site name codes and all other matters herein are
subject to revision. Users of
PartBorPartD.com
should consult their legal advisor or health care consultant
about claims to be filed for these products. No responsibility is
assumed.
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