AHA Coding Clinic® for HCPCS - 2004 Issue 4

New drugs, biologicals and radiopharmaceuticals before creation of HCPCS

Effective January 1, 2004, Section 621(a)(1) of the Medicare Modernization Act (MMA) requires CMS to pay 95 percent of Average Wholesale Price (AWP) for an outpatient drug or biological for which a HCPCS code has not been created. As an interim approach, CMS published Transmittal 188, issued on May 28, 2004, instructing hospitals to bill for a drug or biological that is newly approved by the FDA by reporting the National Drug Code (NDC) for the product along with a new HCPCS code, C9399, Unclassified drug or biological. The Outpatient Code Editor (OCE) suspends the claim for manual pricing...

To read the full article, sign in and subscribe to the AHA Coding Clinic® for HCPCS.

The AHA Coding Clinic for HCPCS includes:

  • The official publication for Level I HCPCS (CPT-4 codes) for hospital providers
  • Also specific Level II HCPCS codes for hospitals, physicians and other health professionals
  • Current newsletters added each quarter
  • Full Archives back to 2001
  • Fully searchable through Find-A-Code's Comprehensive Search
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information page link back to related articles
  • View all the articles associated with any code, right from the code page!
Access to this feature is available in the following products:
  • AHA's Coding Clinic® - HCPCS +Archives

free demo
request yours today
for any budget
sign IN
welcome back!

Thank you for choosing Find-A-Code, please Sign In to remove ads.