Can you bill two 96372?
Asked by: Marcellus Jones | Last update: September 14, 2025Score: 4.5/5 (23 votes)
Can 96372 be billed twice?
Duplicating services already included in another code
Claims may be rejected if services covered by the 96372 CPT code are already included in another code submitted for the same visit. It is crucial to review the documentation and ensure that no duplicative services are being billed separately.
What are the guidelines for billing 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. Requirements for Reimbursement: Direct Physician Supervision – must be done under the direct supervision of an MD.
Can you bill 2 units 20610?
For example, if the provider performs an aspiration and injection on the left knee and a separate aspiration and injection on the right knee, two units of the 20610 code can be reported, each with the designated modifiers for bilateral procedures.
Can you bill 2 units for 95886?
Coding for Electromyography
When four or fewer muscles are tested in an extremity, report +95885; when five or more muscles are tested in an extremity, report +95886. You can report both codes, for a maximum of four units, when all four extremities are tested.
INJECTIONS AND INFUSIONS CODINGIMEDICAL CODING|ED TRAININGI|
How many units can be billed for CPT 96372?
When a patient receives two or three intramuscular or subcutaneous injections, CPT code 96372 should be reported for each injection performed (either IM or SubQ). Modifier 59, Distinct Procedural Service, would be appended to the second and any subsequent injection codes listed on the claim form.
How do I bill for 2 injections?
If a provider wishes to report multiple injections (intramuscular or subcutaneous) of the same therapeutic medication, he or she may choose to report code 96372 (therapeutic, prophylactic, or diagnostic injection [specify substance or drug]). The number of administrations would be reported as the units of service.
Can you bill 20610 and 96372 together?
This means you should not unbundle the code pair. However, code 20610 is also bundled with code 96372 (Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular), but for this pair the modifier indicator is 1.
Do you bill 2 units with a 50 modifier?
If a procedure is authorized for the 150 percent payment adjustment for bilateral procedures (payment policy indicator 1), the procedure shall be reported on a single line item with the 50 modifier and one service unit. Whenever the 50 modifier is appended, the appropriate number of service units is one.
Can you bill 2 units of 96127?
CMS does not limit the number of times CPT code 96127 may be billed per year. There is an MUE limit of 3 units per date of service. Although major insurances typically follow MUE guidelines, they may impose their own limits on the number of times per year that 96127 may be billed.
Can you bill 96372 without an office visit?
You may report 96372 in the facility without the physician present. Injections for allergen immunotherapy have their own administration codes, 95115-95117. Do not report 96365-96379 with any codes that describe a procedure of which IV push or infusion are a part.
Is 96372 a valid CPT code?
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).
Can you bill 99214 and 96372 together?
Can CPT code 99214 and 96372 be billed together? Yes, CPT code 99214 (office visit, established patient) can be billed alongside 96372, but the documentation must clearly show that the injection was separate from the evaluation and management (E/M) service.
What is modifier 51 used for?
Modifier 51 Multiple Procedures indicates that multiple procedures were performed at the same session. It applies to: Different procedures performed at the same session. A single procedure performed multiple times at different sites.
What is a JB modifier used for?
The use of the JA and JB modifiers is required for drugs which have 1 HCPCS Level II (J or Q) code but multiple routes of administration. Drugs that fall under this category must be billed with JA Modifier for the intravenous infusion of the drug or billed with JB Modifier for subcutaneous injection of the drug.
What is the CPT code for B12 injection administration?
Coding a B12 injection
Is 90782, “Therapeutic, prophylactic or diagnostic injection (specify material injected); subcutaneous or intramuscular,” the proper code for administering a vitamin B12 injection in the office if the patient provides the medication?
What is the modifier 52 rule?
Modifier -52 is used to indicate partial reduction or discontinuation of radiology procedures and other services that do not require anesthesia. The modifier provides a means for reporting reduced services without disturbing the identification of the basic service.
What is the 59 modifier used for?
Definitions. Modifier 59 describes a distinct procedural service, and is used to identify procedures and services that are not normally reported together.
What is the 57 modifier used for?
CPT modifier 57 may be used to report the decision for surgery for certain codes. This modifier may be used to indicate that an evaluation and management (E/M) service performed on the same day or the day before a major surgery (090 global days) by the surgeon resulted in the decision to perform the procedure.
How often can you bill 96372?
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 claim form.
Why is Medicare denying 96372?
Using procedure code 96372 to bill for a provided service during a previous visit or billed as an E/M code during the same visit will result in denial. To bill an additional E/M service provided with the injection during the same visit, the healthcare provider must ensure appropriate documentation is in place.
Is 96372 an admin code?
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 you bill 20610 with 2 units?
If the provider performs injections on separate, non-symmetrical joints (e.g., left shoulder and right knee), you may report two units of 20610 and append modifier 59 Distinct procedural service to the second unit (e.g., 20610, 20610-59) to indicate the second procedure occurred at a different joint.
Can you bill 96372 and 95117 together?
Allergy injection codes and E/M codes should not be filed on the same day unless the E/M is separately identifiable. If the E/M is separately identifiable, append modifier -25 to the office visit. Code 96372 does not include injections for allergen immunotherapy. For allergen immunotherapy injections, use 95115-95117.
What is the CPT code for administration of two vaccines?
When reporting administration of combination vaccines, code 90460 is reported for the first component and add-on code 90461 is reported for each additional component (no modifier -51 required).