AHA Coding Clinic® for HCPCS - 2016 Issue 2; For Your Information

Required modifiers for biosimilar biological products

A biosimilar biological product is a biologic medical product that is almost an identical copy of an original product manufactured by a different company. CMS has issued HCPCS codes and modifiers for these biosimilar biological products. As a reminder, under the OPPS biosimilar biological products are required to include a modifier that identifies the manufacturer of the specific product. The modifier does not affect payment determination, but is used to distinguish between biosimilar products that appear in the same HCPCS code but are made by different manufacturers. The table below lists the current biosimilar HCPCS codes, the product(s) that...

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