Important Notice Regarding Billing for Point-of-Use Convenience Kits

Posted June 30, 2015

Blue Cross and Blue Shield of Illinois (BCBSIL) periodically reviews claims submitted by providers to help ensure that benefits provided are for services that are included in our members’ benefit plans and meet BCBSIL’s guidelines. Some providers are submitting claims for point-of-use convenience kits that are used in the administration of injectable medicines. These prepackaged kits contain not only the injectable medicine, but also non-drug components including, but not limited to, alcohol prep pads, cotton balls, band aids, disposable sterile medical gloves, povidone-iodine swabs, adhesive bandages and gauze.

Typically, the cost of a convenience kit exceeds the cost of its components when purchased individually. Non-drug components included in the kits are inclusive of the practice expense for the procedure performed for which no additional compensation is available to the provider. Accordingly, and in an effort to help ensure that services are provided in a cost-effective manner for the appropriate treatment of the BCBSIL member, effective Oct. 1, 2015, only the individual drug components of the kit will be reimbursable to the provider.