New HCPCS Code Approved: What Buy-and-Bill Drug Manufacturers Must Do Next
For pharmaceutical manufacturers launching or managing buy-and-bill products, securing a unique Healthcare Common Procedure Coding System (HCPCS) code…
Medicare Payment Proposal Updates for Cell and Gene Therapies: Coding and Reimbursement Implications for CY 2027
The 2027 proposed ambulatory surgical center (ASC) and hospital outpatient department (HOPD) rule largely…
New Technology Add-On Payment (NTAP): What Manufacturers Must Do to Secure Inpatient Reimbursement
For pharmaceutical and medical device manufacturers launching innovative inpatient therapies, the New Technology Add-On Payment (NTAP) is one of the most…
Selective Enzymatic Debridement
On July 1, 2025, four new CPT® Category III codes — 0973T, 0974T, 0975T, and 0976T — were added to the code set to identify selective enzymatic…
FY 2025 IPPS Final Rule: Capturing the Payment Impact of Housing Instability Z Codes
Effective October 1, 2024, the Centers for Medicare & Medicaid Services (CMS) re-designated the severity level of ICD-10-CM Z codes describing inadequate housing…
Billing Six-Figure Therapies
Cell and gene therapies, such as CAR-T and the newly approved ENCELTO™ (revakinagene taroretcel-lwey), bring patients life-changing results…
CPT 2025 Skin Cell Suspension Autograft Codes: What Providers and Manufacturers Must Do Next
Effective January 1, 2025, eight new CPT codes for skin cell suspension autograft (SCSA)—codes 15011 through 15018—distinguish SCSA from…
C9797 for Complex Embolization: What Hospitals Must Do After Pass-Through Expiration
Effective January 1, 2024, the Centers for Medicare & Medicaid Services (CMS) created HCPCS Level II procedure code C9797 for…
ICD-10-CM Code Q87.83 for Bardet-Biedl Syndrome: What Manufacturers and Providers Must Do Next
For dates of service on or after October 1, 2023, providers have a dedicated ICD-10-CM diagnosis code for…
Know the Latest When Coding Wound Care
Stay up to date on coding practices for autologous blood-derived products associated with chronic wound care…