Since 2000, ReimbursementCodes has been the industry’s go-to partner when it comes to reimbursing for Specialty Drugs against medical claims. Providers, payors and affiliated healthcare organizations rely on our platform with its the coding and clinical data sets; to power workflow, drive accuracy into reimbursements and create a clear understanding for injectable drugs.
ReimbursementCodes is a software-as-a-service application and data platform that delivers a comprehensive crosswalk and conversion of HCPCS/CPT® codes to NDC codes. It includes unit conversions, calculators and workflow features to drive payment integrity for specialty drugs against the medical claim.
The data set accounts for validated pricing using AWP, WAC, ASP (Medicare Allowable), APC and CMAC for each HCPCS/CPT® code. It also includes ICD-10, Min and Max dosing (FDA and Compendia), as well as Age, Gender, Part B or D designation and the applicable Administrative codes. Our data is designed for direct integration with various healthcare systems, such as financial and analytic platforms, pharmacy operations, network contracting, and claims management.