tci Medicare Compliance & Reimbursement - 2004 Issue 24

HOSPITALS: No HCPCS Code? Get Paid Anyway

What hospitals need to know when submitting claims for new drugs. Good news for hospitals. If you've been left out in the cold on reimbursement for yet-to-be coded drugs, things may finally be warming up at the Centers for Medicare & Medicaid Services. Contractors that process hospital outpatient prospective payment claims got the nod from CMS May 28 to begin paying claims for new drugs that have Food and Drug Administration approval -- but no product-specific healthcare common procedure coding system billing code. CMS says hospitals can now use new code C9399 (Unclassified drug or biological) for drugs not...

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