S9365 prior authorization | Blue Cross and Blue Shield of Montana
S9365, Home Infusion Therapy Total Parenteral Nutrition (Tpn); One Liter Per Day Administrative Services Professional Pharmacy Services Care Coordination And All Necessary Supplies And Equipment Including Standard Tpn Formula (Lipids Specialty Amino Acid Formulas Drugs Other Than In Standard Formula And Nursing Visits Coded Separately) Per Diem, is on the Blue Cross and Blue Shield of Montana commercial prior authorization list. Not a coverage or referral decision.
- Code
- S9365
- Description
- Home Infusion Therapy Total Parenteral Nutrition (Tpn); One Liter Per Day Administrative Services Professional Pharmacy Services Care Coordination And All Necessary Supplies And Equipment Including Standard Tpn Formula (Lipids Specialty Amino Acid Formulas Drugs Other Than In Standard Formula And Nursing Visits Coded Separately) Per Diem
- Source
- 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 294 Original policy