AHA Coding Clinic® for HCPCS - 2005 Issue 3; FOR your INFORMATION

Updated payment rate for HCPCS drug code J0135

The payment rate for drug code J0135, Injection, Adalimumab, 20 mg, was incorrect in the April 2005 OPPS PRICER. The payment rate was corrected in the July 2005 OPPS PRICER, effective for the services that were provided between April 1, 2005 and the July 5, 2005 (implementation date of July 2005 OPPS OCE update). By September 15, 2005, Fiscal Intermediaries (FI) shall mass adjust all claims between the above dates that were processed to payment between April 1, 2005 and July 5, 2005. The corrected payment rate for this drug is $294.63. ...

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