2/17/2014

Beginning on February 17, 2014, Cigna will start requesting additional documentation for injectable claims if:

  • The claim is submitted using dosage instead of the appropriate Healthcare Common Procedure Coding System (HCPCS) units.
  • The proper HCPCS units cannot be determined based upon the claim information submitted.

Injectable drug claims must be submitted in HCPCS units, not dosage units. When a claim is submitted using dosage versus the appropriate HCPCS units, the units billed can exceed the daily maximum limit and result in overpayment.

An educational article reviewing proper claim submission practices for injectable claims will appear in the April edition of Cigna's Network News.