a. New HCPCS Codes for Drugs and Biologicals Separately Payable under the ASC Payment System Effective October 1, 2010
Five new HCPCS codes have been created for drugs that are payable as covered ancillary services for dates of service on and after October 1, 2010. The new HCPCS codes, the short descriptors, the long descriptors, and payment indicators are identified in Table 1 below.
The new separately payable drug and biological codes and their payment rates are included in the October 2010 ASC DRUG file.
Table 1 – New Drugs and Biologicals Separately Payable under the ASC Payment System Effective October 1, 2010
HCPCS Code | LongDescriptor | Short Descriptor | Payment Indicator Effective 10/01/10 |
C9269 | Injection, C-1 esterase inhibitor (human), Berinert, 10 units | C-1 esterase, berinert | K2 |
C9270 | Injection, immune globulin (Gammaplex), intravenous, non-lyophilized (e.g. liquid), 500 mg | Gammaplex IVIG | K2 |
C9271 | Injection, velaglucerase alfa, 100 units | Velaglucerase alfa | K2 |
C9272 | Injection, denosumab, 1 mg | Inj, denosumab | K2 |
C9273 | Sipuleucel-T, minimum of 50 million autologous CD54+ cells activated with PAP-GM-CSF in 250 mL of Lactated Ringer’s, including leukapheresis and all other preparatory procedures, per infusion | Sipuleucel-T, per infusion | K2 |