If you work as a medical coder, you’ll certainly need to apply the CPT code 96372 in many different scenarios during the course of your career. Unfortunately, despite this, using 96372 CPT code correctly is a challenge for coders all around the country. As a result, tens of thousands of medical claims are repeatedly rejected, and healthcare professionals do not get paid for the services they render.
It might assist in streamlining your billing process to know when and how to use the CPT code 96372. The foundation of a physician’s job when billing for patient services is accurate medical coding. Therefore, it’s vital to ensure that you reimburse your services as quickly as possible.
In order to correctly bill for the services you provide to your patients, it is crucial for a medical coder to understand how to use CPT code 96372.
What is CPT CODE 96372?
The 96372 CPT code applies to any drug, fluid, or other diagnostic, therapeutic, or prophylactic substance that a doctor or assistant provides. This has accomplished by administering an injection into the patient’s body either subcutaneously (96372), intravenously (96373), or intramuscularly (96372).
Additionally, it can also be administered for infusion through an intravenous catheter or intravascular access device (96374 CPT code is used for billing a single or initial substance). Patients may bill under CPT 96375 or 96374 for subsequential follow-up IV pushes after 30 minutes.
Reimbursement Pre-Requisites
When the injection is carried out independently or in combination with other procedures or services, as allowed by the National Correct Coding Initiative (NCCI) procedure to procedure editing, CPT code reimbursement is permitted. When billed alongside an Evaluation and Management (E/M) Service (CPT codes 99201-99499) by the same rendering provider on the same day of service, separate reimbursement for CPT code 96372 will not be permitted. Enter the name and dosage of any drugs the doctor has suggested on the CMS-1500 Box 19 or the relevant loop and section of the 837P.
Related 96372 CPT Codes
The following codes are very similar to CPT code 96372, including:
CPT 96373: Therapeutic, diagnostic, or preventative intra-arterial injection,
CPT 96374 – Intravenous push injection of a single or initial drug or substance for therapeutic, diagnostic, or preventative purposes
CPT 96375 – Intravenous administration of a fresh drug or chemical for therapeutic, diagnostic, or preventative purposes
CPT 96376 – Therapeutic, diagnostic, or prophylactic injection of the same drug or substance administered intravenously again or again
CPT 96377 – Application of an on-body injector, such as the insertion of a cannula, for therapeutic, diagnostic, or prophylactic injection.
CPT CODE 96372; Common Medical Billing and Coding Guidelines
When billing for the 96372 CPT code, keep in mind the following basic guidelines:
- Only procedures carried out under the strict direct supervision of a healthcare practitioner are eligible for billing under CPT code 96372 in an institutional environment.
- The Code must be a separate bill for each injection, not for every dose of the drug administrated.
- Consequently, even if you inject many different drugs simultaneously, you will only need one billing.
- The intramuscular or subcutaneous injection of the medication must support by the treatment strategy developed by the doctor and the patient’s medical history.
- A procedure CPT 96372 does not permit using highly complex biological agents or drugs, such as chemotherapy treatments. CPT codes 96401 and 96402 utilize to Bill the administration of these medications.
- Certain vaccinations cover under CPT code 96372. Usually, the codes for vaccinations are 90471 or 90472. The administrative code for flu vaccinations in Medicare is G0008.
- Injections for allergen immunotherapy could not documented by CPT Code 96372. Instead, Physicians or medical coders can use the CPT codes 95115-95117 to record injections used in allergen immunotherapy.
- You cannot bill for the same treatment again if the need for the injection Was determined at the last visit (billed as an E/M code). If an extra E/M service has delivered in addition to the injection, you could bill for both the injection and the E/M code at the same visit. That E/M service would need to have the correct paperwork.
Relation of 96372 CPT Code with Modifier 59
The services or procedures which might be precise and now no longer frequently billed collectively on a similar day are commonly appended with modifier 59. Instead of the use of modifier 59, we might also additionally use 76 or 77. At the same time, the identical or a distinctive medical doctor plays a carrier or remedy at the identical anatomical site. Services documentation has to consist of using Modifier 59. These are the subsequent motives while modifier 59 desires to append with CPT 96372:
For billing purposes, you can only submit one unit of code 96372; however, if the volume of an intramuscular or subcutaneous injection split-up between two or three syringes, you can submit as many units as you wish. You would only bill for CPT code 96372 twice along with their drug supply codes and a modifier 59 code on the second injection code, for instance, if you had to deliver two different drugs to a patient but had to use three different injections to do so:
Intramuscular or subcutaneous injection used for therapeutic, diagnostic, or preventative purposes; CPT 96372
CPT 96372-59 (Specific Procedural Service: Therapeutic, Diagnostic, or Prophylactic Injection, Specify Drug or Substance; Intramuscular or Subcutaneous).
If a patient receives an injection, but the Evaluation and Management service is not associated with the service of giving the patient an injection, modifier 25 must also be included in the Evaluation and Management code. For instance, a patient who visits your clinic complaining of shoulder pain but after checking him carefully diagnosed with a respiratory infection. In order to treat the patient’s respiratory infection, the doctor gave him an injection of Vancomycin.
In this instance, the medical coder will add modifier 25 to an E/M code for shoulder pain and modifier 59 to CPT code 96372 to deliver the Vancomycin.
How does NEO MD take care of the outsourced Medical Billing and coding?
Since Medical Billing and coding tasks can be pretty tedious. Therefore, it might not be a good idea to handle these procedures internally from an economic or strategic standpoint. Maintaining compliance with the rules and regulations that are constantly changing is another difficult task for medical practices. Coding for CPT CODE 96372 and other codes is therefore peculiar because the industry is changing so quickly.
Our devoted staff of Medical Billing and coding can assist you in expanding your company. Our crew keeps an eye on all 96372 CPT Coding guidelines in order to optimize reimbursement. Reduced risk of claim denial and refusal comes from real-time, speedy, accurate, error-free coding of each claim and an early evaluation to assure claim eligibility.
Top Revenue Cycle Management companies in the US govern a large number of emerging Medical Billing companies. Very few Medical Billing companies likely don’t have their services known by healthcare providers.
All practices can benefit from our services, no matter how big or small these practices are. Our services help lower overhead expenses brought on by incorrect billing. When required, we update data, fix flaws in processes, and quickly verify and rectify problems. We carefully monitor legislative developments that might boost operational efficiency and cash flow. Additionally, we regularly update our Revenue Cycle Management services to ensure they comply with CMS guidelines.
What Makes NEO MD the Best Medical Billing Company?
NEO MD stood best among competitors due to the following core;
- Our experts work hard to reduce your front-end denials by 20%.
- Improve RCM system efficiency with a robust credentialing team
- Provide fortnightly financial and practice overviews
- Offer internal Medical Billing audits to uncover loopholes
- Refunds adjustment and Payment posting to improve the cash flow.
- Offer Services that are easily scalable at all times.
- Offer Provider & Staff Productivity Analysis
- Use the latest technology and tools.
- Identify potential under, over, and incorrect coding scenarios
- We have consistently increased the collection rate for our clients because of the faster increase in the accuracy of fees and collection.
- Out of Network Negotiations.
- Provide coding services (Particularly well-versed in handling CPT Code 96372 as it involves the highest denials rate).
- Deliver customized Revenue Cycle Management Services to unearth operation shortcomings.
Let’s schedule an appointment and discuss it in-depth with Medical Billing and Coding specialists. Contact us now at ([email protected]) or (929) 502-3636).