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Provider-Administered Drugs Coding Policy
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
Blue Cross Blue Shield of Mississippi's provider-administered drugs coding policy was updated on 04/10/2026 to state that drug administration codes 96372, 96401, or 96402 may be billed along with the 11-digit NDC of the drug administered. The policy describes this NDC billing requirement as effective January 1, 2023. Provider-administered drugs must be reported with the specific CPT or HCPCS drug code, and NOC codes are used only when no specific code is available.
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What to do
Action · 6 steps
01Billing team: For subcutaneous or intramuscular provider-administered drugs, report the valid 11-digit NDC and quantity in loop 2410 of the 837P claim, with the drug administration code (such as 96372) on the service line.
02Report each administration on a separate line with its own NDC when more than one injection is given on the same day by the same provider.
03When a portion of a single-use or multi-use vial is discarded, append modifier JW in loop 2400 SV101-3 and document in the medical record both the amount administered and the amount wasted or discarded.
04When an E/M visit is billed on the same day as drug administration by the same provider, append modifier 25 to the E/M only if it is significant and separately identifiable.
05If a drug is available in both provider-administered and self-administered injectable forms, use the provider-administered form when billing the medical benefit.
06Self-administered drugs billed through the medical benefit may be denied, along with their administration codes.
Codes mentioned
963729640196402J0517J0638J0717J0897J1442J1447Q5101Q5110J0896J2182J2353J2357J2506Q5108Q5111Q5120J2793J3245Q5122
Original notice
Provider-Administered Drugs Coding Policy
bcbsms.com · Always check the source before changing claims.
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