Question:
In Addendum B of the hospital OPPS, I see several different SIs listed for drugs. What do these letters indicate?
Answer:
The four most commonly assigned payment status indicators (SIs) for drugs and biologicals are listed below along with a description of their meanings.
| SI | Item and Payment Status |
| G | Pass-through drugs and biologicals: Paid under OPPS; separate APC payment |
| K |
Nonpass-through drugs and nonimplantable biologicals, including therapeutic radiopharmaceuticals: Paid under OPPS; separate APC payment |
| L |
Influenza vaccine; pneumococcal pneumonia vaccine: Not paid under OPPS; paid at reasonable cost; not subject to deductible or coinsurance. |
| N |
Items and services packaged into APC rates: Paid under OPPS; payment is packaged into payment for other services, so there is no separate APC payment. |
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