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CommercialBilling CodesHigh impact

Provider-Administered Drugs Coding Policy

Blue Cross & Blue Shield of Mississippi·MS · Oncology, Rheumatology, Endocrinology +4 more·Coding
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Days to comply

Summary

BCBS of Mississippi updated their provider-administered drugs coding policy, requiring specific CPT codes for drug administration (96372, 96401, 96402) with mandatory 11-digit NDC reporting in loop 2410, and prohibiting chemotherapy administration codes for certain subcutaneous/intramuscular drugs that must use CPT 96372 instead.

Action Required

Action needed
Immediately: Billing team must update system to require 11-digit NDC codes in loop 2410 for all subcutaneous/intramuscular drug administrations using CPT 96372, 96401, or 96402. Stop using chemotherapy administration codes (96401-96549) for the listed drugs including Fasenra, Ilaris, Cimzia, Prolia, Neupogen, and others - use CPT 96372 instead. Add modifier -JW for discarded drug portions. Update encounter forms to capture NDC and quantity information. Claims may be denied without proper NDC reporting and correct administration codes.

Affected Billing Codes

96372
96401
96402
96365
96366
96367
96368
96369
96370
96371
96373
96374
96375
96376
96377
96378
96379
96360
96361
96549
99202
99203
99204
99205
99211
99212
99213
99214
99215
99499
J0517
J0638
J0717
J0897
J1442
J1447
Q5101
Q5110
J0896
J2182
J2353
J2357
J2506
Q5108
Q5111
Q5120
Q5122
J2793
J3245