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Key Medicare billing requirements for J2941 claims: The drug must be physician-administered, not self-administered by the patient The National Drug Code (NDC) must appear on the claim in the required format A covered ICD-10-CM diagnosis code must establish medical necessity Prior authorization may apply, depending on the Medicare Advantage or supplemental plan Place of service must match an appropriate outpatient or office setting Pro Tip Pull the CMS ASP drug pricing file each quarter before you finalize your fee schedule for somatropin