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How should a provider bill when using a “dummy/local” code on a drug approved through Program Exception (PE)?

April 26, 2017Approved code drug exception PE program Provider

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How should a provider bill when using a “dummy/local” code on a drug approved through Program Exception (PE)?

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Response: When approved through PE, the provider must use the “dummy/local” code assigned to the drug. The drug must be billed as a medical supply when billing through the Web and using PROMISe. The provider may not use the actual NDC number when the drug is approved through PE.