96372 CPT Code: Administration And Injection Coding Guidelines

CPT code 96372 describes the administration of an injection, subcutaneous or intramuscular, to a patient. Here are some coding guidelines for using this code:

1. Indications for use: Code 96372 is used for therapeutic, prophylactic, or diagnostic injections. It should not be used for the administration of oral, intravenous, or intrathecal drugs.
2. Single or multiple injections: Each injection given should be coded separately using 96372. This means that if multiple injections are given to the same patient during a single encounter, each injection should have its own line item on the claim and be reported separately using 96372.
3. Modifiers: Modifiers can be used with code 96372 to indicate additional services provided during the encounter, such as a different diagnosis or a different route of administration. Commonly used modifiers with 96372 include -25 (significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) and -59 (distinct procedural service).
4. Documentation: It is important to document the specific injection(s) administered, the site(s) of injection, and the reason for the injection(s) in the patient’s medical record. This documentation will support the use of code 96372 and ensure accurate billing.
5. Payment: Reimbursement for code 96372 varies depending on the payer and the specific circumstances of the encounter. It is important to verify payer-specific policies and guidelines to ensure appropriate reimbursement.

Overall, it is important to use code 96372 accurately and appropriately to ensure proper reimbursement and avoid potential audit or compliance issues.