icd 9 code for 96372

96372 Therapeutic, prophylactic or diagnostic injection (specify substance or drug); subcutaneous or intramuscular 96373 Therapeutic, prophylactic or diagnostic injection (specify substance or drug); intraarterial 96374 Therapeutic, prophylactic or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug

Full Answer

What does Procedure Code 96372 mean?

The Current Procedural Terminology (CPT) code 96372 as maintained by American Medical Association, is a medical procedural code under the range - Therapeutic, Prophylactic, and Diagnostic Injections and Infusions (Excludes Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration).

What does 96372 mean?

With all of this in mind, how and when should providers use the 96372 CPT code? The 96372 CPT code is is a procedural code defined as therapeutic, prophylactic, and diagnostic substance by subcutaneous or intramuscular injections and infusions. .

What is medical code 96372 used for?

What does CPT 96372 mean? prophylactic. The CPT code 96372 should be used–Therapeutic, prophylactic, or diagnostic injection. However, you can bill for the injection and an E/M code at the same visit if there was an additional E/M service provided in addition to the injection.

What diagnosis code should you use with CPT code 96372?

The administration of the following drugs should not be billed using a chemotherapy administration code. Instead, the administration of the following drugs in their subcutaneous or intramuscular forms should be billed using CPT code 96372. For the administration of a drug using an On-Body Injector bill with CPT code 96377.

What diagnosis code goes with 96372?

CPT® code 96372: Injection of drug/substance under skin or into muscle | American Medical Association.

Can CPT code 96372 Be bill with an office visit?

We always bill 96372 w/ office visit when injection was given with direct physician/other qualified health care professional; I work at urgent care facility. Hope this help.

How do I bill CPT 96372?

The 96372 CPT code is to be billed for each injection performed on a patient. Modifier 59 should be used when the injection is a separate service from other treatments.

How do I bill for therapeutic injections?

The CPT code 96372 should be used–Therapeutic, prophylactic, or diagnostic injection.

Can you bill 96372 by itself?

Can CPT Code 96372 Be Billed Alone? Yes, it is allowed to be billed alone when the injection is performed alone or in conjunction with other procedures/services as allowed by the National Correct Coding Initiative (NCCI) procedure to procedure editing.

How many times can you bill 96372?

The IM or SQ injection can be billed more than once or twice. If the drug is prepared and drawn up into two separate syringes and it is then administered in two individual injections in two distinct anatomic sites, you can bill two units of code 96372 (billing second unit with modifier 76).

Can a nurse Bill 96372?

Question: If a patient pays for her medicine and goes to the clinic for the nurse to give the injection, we can bill CPT 96372 (Therapeutic, prophylactic or diagnostic injection ...).

How do you code the depo shot?

Effective January 1, 2013, injection administration of medroxyprogesterone acetate (Depo-Provera) should be reported using HCPCS code J1050 (Injection, medroxyprogesterone acetate, 1 mg).

What is the ICD 10 code for medication management?

ICD-10-PCS GZ3ZZZZ is a specific/billable code that can be used to indicate a procedure.

Can 96372 be billed with 99214?

Yes, as long as your documentation supports it.

Can 96372 be billed with 99213?

Guest. 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 code injections and infusions?

Injection and Infusion Coding Scenarios How is this reported? Answer: Coders should use 96365 for the first hour of infusion, 96366 for the second hour of infusion, and for the IV push of the same drug.

Overview

The clinical examples and their procedural descriptions, which reflect typical clinical situations found in the health care setting, are included in this text with many of the codes to provide practical situations for which the codes would be appropriately reported.

Typical patient description

A 70-year-old female diagnosed with pneumonia receives an intramuscular injection of antibiotic (e.g., ceftriaxone).

Care components

Therapeutic, prophylactic or diagnostic injection (specify substance or drug); subcutaneous or intramuscular.

About the CPT code set

Medical knowledge and science are constantly advancing, so the CPT Editorial Panel manages an extensive process to make sure the CPT code set advances with it.

What is CPT 96372?

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.

What is the purpose of 96372?

The primary intent of an injection as described by 96372 is generally to deliver a small volume of medication in a single shot. The substance is given directly by subcutaneous (sub-Q), intramuscular (IM), or intra-arterial (IA) routes, as opposed to an intravenous (IV) injection/push that requires a commitment of time.

What is the code for preventive medicine?

The Preventive Medicine codes (99381-99412, 99429) do not need Modifier 25 to indicate a significant, separately identifiable service when reported in addition to the diagnostic and therapeutic Injection service. The Preventive Medicine codes include routine services such as the ordering of immunizations or diagnostic procedures.

Does the E/M code need a modifier?

Since the Injection procedure does not include the components of a Preventive Medicine E/M service, the Injection can be reported separately and the Preventive Medicine E/M code does not need a modifier to indicate it is distinct or separate from the Injection procedure.

Is CPT code 96372-96379 paid?

As this code is applied incorrectly, providers are not being paid for this injection administration code. CPT codes 96372-96379 are not intended to be reported by the physician in the facility setting.

What is CPT code 96372?

Per CPT and the CMS National Correct Coding Initiative (NCCI) Policy Manual, CPT codes 96372-96379 are not intended to be reported by the physician in the facility setting. Thus, when an E/M service and a therapeutic and diagnostic injection service are submitted with CMS Place of Service (POS) codes 19, 21, 22, 23, 24, 26, 51, 52, and 61 for the same patient by the Same Individual Physician or Other Health Care Professional on the same date of service, only the E/M service will be reimbursed and the therapeutic and diagnostic Injection (s) are not separately reimbursed, regardless of whether a modifier is reported with the injection (s).

When did the 90772 code change?

Although this change was made by the American Medical Association (AMA) effective January 1, 2009, providers are allowed to use either the 90772 code or the 96372 code until April 30, 2009.

How many lesions are there in CPT 11900?

A. The injection is reported with CPT 11900 for up to and including seven lesions or 11901 for more than seven lesions. Note, the descriptor says lesions, not needle sticks. A lesion may involve more than one needle stick.

Is hydration a prophylactic or diagnostic service?

When a physician uses fluid to administer the drug (s), the administration of the fluid is considered part of the therapeutic, prophylactic, or diagnostic service (i.e., not separately reportable). Hydration is not reportable in addition to therapeutic, prophylactic, or diagnostic injections and infusions.

Can 99211 be reimbursed?

CPT 99211: E/M service code 99211 will not be reimbursed when submitted with a diagnostic or therapeutic Injection code, with or without modifier 25. This very low service level code does not meet the requirement for “significant” as defined by CPT, and therefore should not be submitted in addition to the procedure code for the Injection.

General Information

CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

CMS National Coverage Policy

Language quoted from Centers for Medicare and Medicaid Services (CMS), National Coverage Determinations (NCDs) and coverage provisions in interpretive manuals is italicized throughout the policy.

Article Guidance

The Medicare Administrative Contractor has determined in review of submitted claims that there is inappropriate use of CPT codes 96401-96549 for chemotherapy and other highly complex drug or highly complex biologic agent administration.

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.