CQW Panacea-re-brand-rev3

For the Week of August 3, 2015

Question:

In addition to the drugs that Medicare already packages, will there be any new packaged drugs for 2016?

Answer:

In the proposed 2016 hospital outpatient prospective payment system (OPPS) rule, the Centers for Medicare & Medicaid Services (CMS) reported that it conducted a comprehensive clinical review of OPPS drugs that were separately payable in 2015. From the outcome, it proposes to package in 2016 the following based on their primary function as a supply in a surgical procedure:

J0583 Injection, bivalirudin, 1 mg
J7315 Mitomycin, ophthalmic, 0.2 mg J0130 Injection, abciximab

In 2018, CMS proposes that the following be packaged. The reason for the delay is that the drug described by this code currently has pass-through payment status, and this status expires in 2018.

C9447 Injection, phenylephrine and ketorolac, 4 ml vial

 

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