Injectable Drug
Billing and Reimbursement
Policy Number: RP-X-005
Last Updated: Mar. 24, 2022
Submit the HCPCS Level II code that best describes the injection given in terms of the drug and dosage. Codes for injections include the charge for the drug only. The administration charge should be submitted separately. When the dosage given is greater than the HCPCS Level II code definition, use the units field to specify the appropriate number of units.
Example:
The patient received 8 mg. of haloperidol. The common dosage for haloperidol (J1630) is “up to 5 mg.” Two units of service (UOS) should be submitted. The dosage is rounded up to the next unit.
Codes 96379, J3490 and any drug code ending in 99 must include the drug name, dosage and 11-digit National Drug Code (NDC).
Report the drug name, dosage and NDC starting in the loop 2400/NTE segment narrative field for electronic claims.