Policy Updates Reimbursement PoliciesCommercialJanuary 31, 2019

Injectable Substances with Related Injection Services - (Professional)

Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.

Beginning with dates of service on or after May 1, 2019, Empire is 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 our without an injection, J3590 (unclassified biologics) with a zero charge to indicate the biologic contents of the syringe after aspiration must be included on the claim or it 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 empireblue.com/provider.