AHA Coding Clinic® for HCPCS - 2017 Issue 1

Reporting unclassified drugs and biologicals

The Central Office has received several inquiries regarding how to correctly report drugs and/or substances for which there is not a valid Healthcare Common Procedure Coding System (HCPCS) code available.  This article will seek to provide some guidance and clarification on correct reporting.  While many drugs, biologicals and radiopharmaceuticals have a specific HCPCS code assigned, there are many that do not.  For those drugs and biologicals that do not have a valid HCPCS code, when necessary, an unclassified drug or biological HCPCS code would be reported instead.  The term “unclassified” describes the drug or...

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