AHA Coding Clinic® for HCPCS - 2017 Quarter 4; For Your Information
Pass-through status granted to four drugs and biologicals effective October 1, 2017
Medicare has granted OPPS pass-through status for four drugs and biologicals, effective since October 1, 2017. The HCPCS codes and code descriptors for the four drugs and biologicals are listed in the table below. HCPCS Code Long Description C9491 Injection, avelumab, 10 mg C9492 Injection, durvalumab, 10 mg C9493 Injection, edaravone, 1 mg C9494 Injection, ocrelizumab, 1 mg ...
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Article Overview
This article summarizes a Medicare outpatient prospective payment system update related to pass-through status for selected drugs and biologicals effective October 1, 2017. It is useful for hospital outpatient coders, billing teams, and reimbursement staff who need to track HCPCS-level changes and understand which product identifiers were added in this update.
Why This Topic Matters
Updates to outpatient pass-through status can affect charge capture, claims processing, and reimbursement workflows. Keeping track of the affected HCPCS identifiers helps coding and billing teams stay aligned with current Medicare guidance.
What You Will Learn
- Which Medicare outpatient payment update is discussed
- The scope of the drugs and biologicals covered by the update
- Which HCPCS identifiers are listed in the article
- The effective date associated with the update
Who Should Read This
- Hospital outpatient coders
- Medical billers
- Revenue cycle staff
- Compliance teams
- Reimbursement analysts
Codes Discussed
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