Injectable Substances with Related Injection Services reimbursement policy update: professional

Beginning with dates of service on or after May 1, 2019, we are updating our Injectable Substances with Related Injection Services reimbursement policy. The update will reflect that when a claim for an injection service is submitted without the applicable Healthcare Common Procedure Coding System (HCPCS Level II) drug or injectable substance code for the injected drug or substance, the code for the injection service will not be eligible for reimbursement.

 

Additionally, when submitting a claim for an aspiration service, with or without an injection, be sure to submit code J3590 (unclassified biologics) with a zero charge to indicate the biologic contents of the syringe after aspiration, or the service will not be eligible for reimbursement.

 

For additional information, review our updated policy dated May 1, 2019 by visiting the by visiting the Reimbursement Policy page at anthem.com/provider.