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Required documents checklist: Medication order or prescription documenting the drug name, dose, route (SC or IM), and clinical indication Administration record confirming the drug was administered, including the site of injection, lot number, and expiration date Documentation of the clinical indication linking to a specific ICD-10 diagnosis code Drug J-code with units billed matching the actual dose administered Documentation of drug wastage if modifier JW is used If billing E/M with modifier 25 : a separately documented evaluation addressing a distinct condition beyond the injection visit What is the Cost of CPT Code 96372

Industry Response: The compounding pharmacy industry, medical practitioners, and patient advocacy groups pushed back against the Category 2 classification, arguing that the safety data did not support such a restrictive designation

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