Drugs and biological with OPPS pass-through status

CMS has granted pass-through status to two (2) drugs. HCPCS code J0638 , Injection, canakinumab, 1 mg , and code C9286 , Injection, belatacept, 1 mg , a new HCPCS code that became effective October 1, 2011. ...

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Note:  The following article synopsis was NOT provided by the AHA. It was created by Find-A-Code/innoviHealth.

Article Overview

This article summarizes a CMS outpatient prospective payment system update involving drug and biological pass-through status. It is relevant to hospital outpatient coders, reimbursement staff, and others tracking HCPCS changes and effective dates for outpatient payment policy.

Why This Topic Matters

Updates like this can affect how outpatient drug and biological services are tracked in claim workflows and how coding teams monitor current HCPCS activity and CMS payment policy changes.

What You Will Learn

  • Which outpatient payment update is discussed
  • Which CMS-related HCPCS changes are mentioned
  • What general kind of coding and reimbursement information the article covers
  • What effective-date information is included

Who Should Read This

  • Hospital outpatient coders
  • Outpatient reimbursement specialists
  • Revenue cycle staff
  • Coding compliance professionals

Codes Discussed


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The AHA Coding Clinic for HCPCS includes:

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