Tag Archives: drug codes

INSIDE THIS ISSUE Clinical News Drug Reimbursement Code Price Updates Drugs/Devices New Clinical and Billing Information CODE UPDATES Large Price Changes: We identify and report on the codes with the most substantial pricing increases or decreases each month and detail the rationale for the change. Of the 224 AWP Drug Code Price changes this month, […]

Join RJ’s Product and Clinical teams as they walk through the multitude of different combinations of drug claims and pricing methodologies, via clips from the webinar “Shedding Light on Medically Covered Specialty Drug Pricing Methods.” In the following clip, Chris Webb explains the main difference between HCPCS and NDC code level reimbursement. All past RJ […]

INSIDE THIS ISSUE CMS News REMINDER – New HCPCS® Codes are Now Effective Quarterly ASP (Average Sales Price) Pricing File Revised for January 2020 Hospital OPPS (Outpatient Prospective Payment System) Update January 2020 NOC (Not Otherwise Classified) Pricing File Drug Reimbursement Code Price Updates 39 Drug Codes required a recalculation of their AWP Code Price Drugs/Devices […]

INSIDE THIS ISSUE CMS News New HCPCS® Codes Effective January 1, 2020 Now Available Deleted and Revised HCPCS® Codes Effective January 1, 2020 Coming Soon Drug Reimbursement Code Price Updates 39 Drug Codes required a recalculation of their AWP Code Price Drugs/Devices New Clinical and Billing Information CODE UPDATES Large Price Changes: We identify and report […]

$35 billion of drug-related revenue comes from healthcare provider offices. Health plans have established policies that require additional information, not just the HCPCS code. This additional information enables payors to differentiate between drugs that exist under the same billing codes. Recent claims analysis revealed a high degree of confusion from providers on what is required […]

INSIDE THIS ISSUE CMS News New HCPCS® Codes Effective January 1, 2020 Coming Soon Drug Reimbursement Code Price Updates 68 Drug Codes required a recalculation of their AWP Code Price Drugs/Devices New Clinical and Billing Information CODE UPDATES Large Price Changes: We identify and report on the codes with the most substantial pricing increases or decreases […]

INSIDE THIS ISSUE CMS News 2019-2020 Influenza Vaccine Season NDCs Now Available New HCPCS Code J0642-Injection, levoleucovorin (khapzory), 0.5 mg and Revised Code Description for J0641-levoleucovorin, 0.5mg Coming Soon New HCPCS Drug Q-Codes effective October 1, 2019 New HCPCS Drug J-Codes effective October 1, 2019 New HCPCS Drug Code Revisions and Discontinuations effective October 1, […]

Join RJ’s Jason Young – SVP Clinical Data Operations, Todd Cooperman – SVP Clinical Insights and Analytics, and Chris Webb – Director of Product Development, as they review the drug coding updates, revisions, and issues observed over 2019’s third quarter. Learn about: New and Existing Code Updates – HCPCS Codes: J Codes, Q Codes •  […]

Wondering about the different types of HCPCS (Healthcare Common Procedure Coding System) codes and how they apply to reimbursement? Chris and Jason walk through HCPCS and CPT® (Current Procedural Terminology) code background in this edition of Drug Pricing and Reimbursement 101. These webinar clips from “Shedding Light on Medically Covered Specialty Drug Pricing Methods” touch […]

INSIDE THIS ISSUE CMS News 2019-2020 Influenza Vaccine Season NDCs Now Available New HCPCS Drug Q-Codes effective October 1, 2019 New HCPCS Drug J-Codes effective October 1, 2019 New HCPCS Drug Code Revisions and Discontinuations effective October 1, 2019 Drug Reimbursement Code Price Updates 48 Drug Codes required a recalculation of their AWP Code Price Drugs/Devices […]