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May 2016

Reminder: Follow billing guidelines when purchasing or administering medical drugs

When professional health care providers purchase and administer a medical drug for a Blue Cross Blue Shield of Michigan member, they should bill for both the drug and its administration. They should only bill the national drug code on the drug’s service line. The code shouldn’t be placed on the administration service line.

See the example below:

When professional providers administer a drug they didn’t purchase, they should bill for the administration code only and not include an NDC code.

See the example below:

For additional information on billing, refer to the online provider manual.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2015 American Medical Association. All rights reserved.