Q&A: Drugs recently granted pass-through status

Q: Are there any new drugs that received pass-through status in April?

A: CMS has granted pass-through status for seven drugs beginning April 1. These are listed in Table 3 of the update transmittal. The drugs are:

• C9484, injection, eteplirsen, 10 mg
• C9485, injection, olaratumab, 10 mg
• C9486, injection, granisetron extended release,0.1 mg
• C9487, ustekinumab, for intravenous injection,1 mg
• C9488, injection, conivaptan hydrochloride, 1 mg
• J7328, hyaluronan or derivative, gel-syn, for intra-articular injection, 0.1 mg
• Q5102, injection, infliximab, biosimilar, 10 mg

Of note, Q5102 is a biosimilar, so the appropriate modifier representing the manufacturer will be required for reporting.

Editor’s note: Denise Williams, RN, CPC-H, senior vice president of revenue integrity services at Revant Solutions, in Fort Lauderdale, Florida, answered this question.

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