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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).
The injection codes (96372 and 96373 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intra-arterial) may be reported with any hydration therapy, IV drug administration, or chemotherapy administration during the same encounter. Code assignment for sub-Q, IM, or IA injection procedures does not affect the primary ...
Answer: CPT code 96372… should be reported for each intramuscular (IM) injection performed. Therefore, if two or three injections are performed, it would be appropriate to separately report code 96372 for each injection. Modifier 59, Distinct Procedural Service, would be appended to the second and any subsequent injection codes listed on the ...
Injection: Do not use CPT® 96372 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular. This code does not include injections for allergen immunotherapy. Although hospitals may report injection codes when the physician is not present, physician offices may not.
The Current Procedural Terminology (CPT ®) code 96371 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).
CPT® 96401 is valued at approximately $75, and CPT® 96372 at approximately $25 (Medicare fee schedule). Clearly, this could be a compliance risk or a significant loss of revenue if the correct choice isn’t made. Prolia® is a prescription medicine used to treat osteoporosis (thinning and weakening of bone) in women after menopause who are ...
I billed the drug CPT with a charge of ZERO and billed 90471 for administration. The claim was denied for "routine vaccine not covered", even though it was billed with ICD-10 for exposure to rabies and animal bite. Per the insurance this was to be coded with 96372 as it was a "therapeutic" injection even though it was a vaccine.
In other words, CMS does not require that carriers recognize 96401 for all monoclonal antibodies. And, third-party payers are free to ignore either CMS or CPT® instruction. The bottom line is: Whether you should report monoclonal antibodies using 96372 or 96401 is almost entirely at the payer’s discretion, and may vary from one specific drug ...
Feb 3, 2022. #1. Hi there, I would like to get a second opinion about billing a 96372 with an E/M for the following procedure note. I have another coder stating that it is not appropriate to bill the 96372 for the Toradol injection for the following note due to Medicare NCCI coding policy Chapter 11. I personally believe it should be separately ...
Jun 2, 2020. #1. I need a written rationale to explain to my charge entry person on why a 59 modifier is not to be used with 96372. I have looked at the NCCI and see no listing of a 59 modifier needed. The only thing is I draw a blank on how to word they "WHY". Can someone please help me with composing the answer to "WHY" or provide the ...