Member‑supplied Drug Administration Billing (Coding and Documentation Guidance)
Guidance on coding and documentation when members supply their own drugs (or drugs provided at no cost to provider) for provider administration; affects providers billing Blue Cross Blue Shield - Oklahoma.
New policy established on 9/7/2021.
Annual review performed on 12/20/2022.
Member-Supplied Drug Coverage Criteria
Member-supplied drug billing criteria
Documentation and billing requirements when a member provides the drug:
ALL of the following
- Drug is administered to the member under direct supervision.
- If no E/M service is provided, document CPT code 96372 (Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular).
- Document the drug name, drug code, and drug dosage.
- Report a zero-dollar ($0.00) charge for the drug.
Billing Codes for Administration
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