Drugs and Biologicals with OPPS Pass-Through Status

As of October 1, 2016, these four drugs and biologicals were granted outpatient prospective payment system (OPPS) pass-through status. The HCPCS codes for the drug and biologicals in addition to their long descriptor are listed below. HCPCS CodeLong Descriptor* C9139 Injection, Factor IX, albumin fusion protein (recombinant), Idelvion, 1 i.u. * C9481 Injection, reslizumab, 1 mg * C9482 Injection, sotalol hydrochloride, 1 mg * C9483 Injection, atezolizumab, 10 mg * Please note HCPCS codes C9139 and C9481 will be replaced by HCPCS J codes, effective January 1, 2017. The HCPCS J codes are listed in the table below...

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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 covers outpatient prospective payment system (OPPS) pass-through status for a small set of drugs and biologicals, including code updates tied to an effective date change. It is relevant to hospital outpatient coders, charge capture staff, and reimbursement professionals who track HCPCS updates for drug and biological billing. The article presents the covered HCPCS identifiers and highlights which entries are being replaced in the following year.

Why This Topic Matters

OPPS pass-through updates affect how certain drugs and biologicals are tracked in hospital outpatient settings and may involve code transitions that need to be reflected in charge systems and claims workflows. Keeping these updates current helps reduce coding mismatches and supports accurate outpatient billing.

What You Will Learn

  • Which drugs and biologicals are included in the OPPS pass-through update
  • How the article frames HCPCS code changes across calendar years
  • Which HCPCS identifiers are listed in connection with the update
  • What effective date context is provided for the pass-through status information

Who Should Read This

  • Hospital outpatient coders
  • Charge capture specialists
  • Revenue cycle staff
  • Billing compliance teams
  • Reimbursement analysts

Codes Discussed

  • HCPCS Level II: C9139
  • HCPCS Level II: C9481
  • HCPCS Level II: C9482
  • HCPCS Level II: C9483
  • HCPCS Level II: J7202
  • HCPCS Level II: J2786

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