This article outlines the coding guidelines and descriptions of HCPCS Codes J3490 & J3590.
Description of J3490: Unclassified drug.
Description of J3590: Unclassified biologic.
Billing Guidelines For HCPCS Codes J3490 & J3590
HCPCS J3490 (unclassified drug) and J3590 (unclassified biologic) are the HCPCS codes that are reported for medications that are biological but have not yet been established, to which the HCPCs code has been assigned.
To report a new medicine that is biological and has been approved by the Food and Drug Administration with a specific HPCCS code, use the code C9399 for the unclassified medicine.
When submitting a Medicare application for a drug that is biological, it is important to review the full and lengthy descriptors applicable to the HCPCs code.
Hospital providers should ensure that the unit of drug administered to the patient is specified in dosing units as specified in the full HCPCS descriptor.
Providers and hospitals should not charge the device according to how the medicine is packaged, priced, stored or stored.
According to the CMS, the allowable payments for each drug are calculated from the 106 ASPs based on data from drug manufacturers.
Each medicine is assigned a payment limit that is permitted according to the HCPCs dosage, as confirmed by the CMS ASPs for drug prices published in a table.