What is 96372 CPT code used for?

Subcutaneous and Intramuscular Injection Non-Chemotherapy Instead, the administration of the following drugs in their subcutaneous or intramuscular forms should be billed using CPT code 96372, (therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular).

Can CPT code 96372 Be bill with an office visit?

If you administer an injection in your office, e.g., naltrexone extended-release (Vivitrol®) or depot antipsychotics, you can bill for the administration of the injection separately from the billing for the visit itself. The CPT code 96372 should be used–Therapeutic, prophylactic, or diagnostic injection.

Can 20610 and 96372 be billed together?

They are not used together for the same injection. The 20610 or 20605 are the admin codes for the joint injection the J code is the drug/substance injected. The 96372 is not coded for a joint injection.

Is CPT 96372 covered by Medicare?

A: Medicare requires the use of CPT code 96372 –Therapeutic, prophylactic, or diagnostic injection, specify substance or drug; subcutaneous or intramuscular for the administration of biologics. Medicare does allow for multiple units/injections using this code.

Can I bill an office visit with an injection?

Answer: Unfortunately, no. It is true that an evaluation and management code, an E/M or office visit, can be reported with a minor procedure such as an injection, but only if the E/M is significant and separate and exceeds the “pre-service evaluation” that is inherent to the injection.

How do you bill for injection only?

You only need the documentation to support a significant encounter from the injection administration. You would never bill the E&M code and the Jcode for the drug only. If you cannot support a significant office encounter then you would bill the injection admin and the J code and not the E&M.

What modifier is needed for CPT 96372?

modifier 25
required for the Injection service, modifier 25 may be reported for the E/M service in addition to 96372-96379.

Can 99213 and 96372 be billed together?

Yes. Put modifier-25 on your office visit and your 96372 will get paid as long as the patients insurance benefits cover it.

How do you bill Arthrocentesis?

20610: Arthrocentesis, aspiration and /or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance, with permanent recording and reporting.

How do I bill for 2 injections?

Question: What is the appropriate CPT code to report when a patient receives two or three intramuscular injections? Answer: CPT code 96372… should be reported for each intramuscular (IM) injection performed.

Is there a problem with CPT 96372 diagnostic injection?

Across the country, in offices and facilities, coders are having trouble with CPT® 96372 Therapeutic, prophylactic, or diagnostic injection, specify substance, or drug; subcutaneous or intramuscular. As this code is applied incorrectly, providers are not being paid for this injection administration code.

Is the 99211 code the same as 96372?

Bottom Line: Insurance payers are not paying 99211 when reported on the same date of service as 96372. If you report these codes in combination, the payer will deny the claim.

When to not report an E / M code 96372?

Do not report 96365-96379 with any codes that describe a procedure of which IV push or infusion are a part. Hospitals may not report an E/M code in addition to 96372 or 96373 when the sole purpose of the visit is drug administration. This guidance should resolve any problems you were having with 96372.

When to report 99211 or 96372 for denial?

Typically, 5 minutes are spent performing or supervising these services) for this visit would be inappropriate. Bottom Line: Insurance payers are not paying 99211 when reported on the same date of service as 96372. If you report these codes in combination, the payer will deny the claim.