Imitrex, Is It a Self-Administered Drug?
Published on
Wednesday, May 5, 2021
Question:
We have another question about self-administered drugs based on prior outpatient FAQs for Lovenox and insulin. (Click for the Lovenox article and for the insulin article.) Is the drug ‘Imitrex’ a self-administered drug for Medicare? Usually, we see this given to patients in the ER who present with migraine type headaches.
Answer
For Palmetto, the Medicare Administrative Contractor (MAC) for Jurisdictions J and M, Imitrex is a self-administered drug when given by subcutaneous route. For Medicare, you would NEVER report a subcutaneous injection (CPT code 96372) for Imitrex. If you are under the jurisdiction of a different MAC, check their respective self-administered drug list as the drugs can vary from one MAC to the next.
Here is a link to Palmetto’s self admin drug list. It is a very handy reference to see which injectable drugs are considered self-administered drugs at least – for hospitals under the jurisdiction of Palmetto GBA.
Local Coverage Article for Self-Administered Drug Exclusion List
Article Author: Jeffery Gordon, RN, MSN, CCA, COC
Jeffery Gordon, RN, MSN, CCA, COC, is the Manager of Outpatient Medical Review at Medical Management Plus, Inc. Jeff has over thirty-five years of experience in healthcare including Critical Care, Infection Control, Quality Assurance, Medical Necessity, Outpatient Coding, Medicare Claims data analysis and Medical Record review.
