How to bill 2 units of 96372?
Asked by: Jacey Pouros | Last update: January 21, 2026Score: 4.9/5 (8 votes)
How do you code multiple 96372?
Each administration of the injection should be documented separately using the 96372 CPT code. If a patient receives multiple injections in a single visit, each injection should be accounted for. It is important to accurately record the number of units for each administration to ensure proper billing and reimbursement.
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.
How to bill multiple units of 20610?
Multiple Units and Bilateral Procedures for 20610 CPT Code
However, there are scenarios where multiple units may be reported. If the procedure is performed in more than one major joint, each joint can be reported with a separate unit of the 20610 code.
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.
J3301 and Medicare Medical Coding
Can 96372 be billed with 2 units?
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.
What modifier is used for multiple procedures?
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.
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.
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.
Can you bill 20610 with 50 modifier?
The appropriate site modifier (RT or LT) must be appended to CPT code 20610 or CPT code 20611 to indicate if the service was performed unilaterally and modifier (-50) must be appended to indicate if the service was performed bilaterally.
When to use 59 or 51 modifier?
Modifier -51 would be attached because the biopsy is the lesser-valued procedure done at the same session, and modifier -59 would be attached to indicate that the biopsy, which is normally bundled with excision of the same lesion, was done on a separate lesion from the one that was excised.
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.
What is the 52 modifier in billing?
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.
How do I bill 96372 to Medicare?
CPT code 96372 should be adequately documented to indicate that it is a particular or independent service from other services provided on the same day. Using procedure code 96372 for vaccinations is inappropriate; instead, codes like 90471, 90472, or G0008 (for Medicare) should be used.
Do you bill 96372 with J3301?
Yes, CPT code 96372, which is for therapeutic, prophylactic, or diagnostic injection, can be billed alongside J3301 if an injection of triamcinolone acetonide (Kenalog) is administered. J3301 covers the medication, while 96372 covers the injection procedure itself, so both can be billed together if applicable.
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.
Can you bill 96372 with 2 units?
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.
How many units do you bill with modifier 50?
If the procedure is performed bilaterally, modifier 50 should be appended to the procedure code with 1 unit of service.
What is the difference between 95885 and 95886?
Use codes 95870 or 95885 when four or fewer muscles are tested in an extremity. Use codes 96860– 95864 or code 95886 when five or more muscles are tested in an extremity.
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.
Do you bill 96372 with J0171?
Answer: Use of an EpiPen® represents an injection of epinephrine. As such, it would be appropriate to code its administration using codes 96372 (Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular) and J0171 (Injection, adrenalin, epinephrine, 0.1 mg).
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.
Can you bill for two procedures at the same time?
Using modifier 51 allows you to be paid for multiple procedures in the same day that are not bundled together. Medicare payers do not require modifier 51 on the claim form, Commercial payer policy varies.
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.
What is the 33 modifier used for?
Current Procedural Terminology (CPT) modifier 33 can be used when billing for ACA-designated preventive services with a commercial payer. The addition of modifier 33 communicates to a commercial payer that a given service was provided as an ACA preventive service.