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Try CasePilot| Short Descr | Inj epcoritamab-bysp 0.16 mg | Related Drugs | EPKINLY | Coverage | Carrier Priced | Pricing Indicator(s) | 51 – Drugs | MPI | A – Not applicable, as HCPCS priced under one methodology | ASC Payment Group Code | YY – 1/01/2024 | BETOS | O1D – Chemotherapy | TOS Code(s) | 1 – Medical care | Added Date | 1/1/2024 | Status Code | Excluded from Physician Fee Schedule by Regulation | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Pass-Through Drugs and Biologicals | ASC Payment Indicator | Drugs and biologicals paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS rate. | MUE | 300 | MUE | 300 | OTS Orthotic | No |
| JZ | Zero drug amount discarded/not administered to any patient | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | X2 | Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services | JW | Drug amount discarded/not administered to any patient | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days |
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| 2024-01-01 | ReActivated | Reactivated with new description. |
| 2024-01-01 | Added | Code added for epcoritamab-bysp |
| 2023-07-01 | Added | Code scheduled to be a new code for pemetrexed (sandoz), effective July 1, 2023, however, before becoming active, it was removed from the official update file. |
| 2023-06-30 | Deleted | Although originally released by CMS as a new code for pemetrexed (sandoz), effective July 1, 2023, a later release removed this code (before it ever became active) stating that it is a duplicate of J9297. |
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