Is 96372 an admin code?
Asked by: Ike Lakin | Last update: August 31, 2025Score: 4.8/5 (23 votes)
Is 96372 a valid CPT code?
The 96372 CPT code is is a procedural code defined as therapeutic, prophylactic, and diagnostic substance by subcutaneous or intramuscular injections and infusions. .
What is the difference between CPT code 20610 and 96372?
CPT code 20610 is used for joint or bursa injections (such as steroid injections into the knee), while 96372 is for intramuscular or subcutaneous injections that do not involve joints. Essentially, 20610 relates to targeted joint procedures, and 96372 applies to general therapeutic or diagnostic injections.
What is the admin CPT code for joint injection?
The CPT codes for arthrocentesis aspiration or injection procedures are 20600-20611. Accurate reimbursement depends on reporting the services provided using all the appropriate code sets and modifiers.
Can you bill a 96372 with an office visit?
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.
MEDICAL BILLING AND CODING FOR VACCINE ADMINISTRATION
What is the admin code for 96372?
CPT code 96372 is used for certain types of vaccinations. Most vaccinations are typically coded with 90471 or 90472. Medicare uses G0008 as the administration code for flu vaccinations. Procedure code 96372 is billed for injections related to the provision of chemotherapy services.
What is the CPT code 96372 billing guidelines?
When should CPT code 96372 be used? CPT code 96372 should be used when administering injections for therapeutic, prophylactic, or diagnostic purposes to ensure billing accuracy and reimbursement.
Can you bill an office visit with a joint injection?
Answer: Unfortunately, no. It is true that an evaluation and management code, an E/M or office visit, can be reported with a minor procedure such as an injection, but only if the E/M is significant and separate and exceeds the “pre-service evaluation” that is inherent to the injection.
What is the difference between CPT code 96372 and 90471?
90471 should be used for vaccines and 96372 for drugs. You need to make sure when billing 96372 that you use a 59 modifier on the drug or it won't pay.
What is the admin for injection CPT?
Subcutaneous and Intramuscular Injection Non-Chemotherapy
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 99214 and 96372 together?
The office visit is billable as 99214-25 Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity, along with the injection, 96372.
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?
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 96372 be billed with 20610?
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.
What is the CPT code for medication administration?
The administration of drugs and fluids other than antineoplastic agents, such as growth factors, antiemetics, saline, or diuretics, may be reported with CPT codes 96360-96379.
Can you bill 96372 with 99211?
Answer: You cannot ever bill 99211 with 96372. In fact, according to the Correct Coding Initiative (CCI), no modifier will separate the edit bundling these codes together, so there are no circumstances under which they can be reported together.
What is the admin code for CPT 90471?
Report CPT 90471 for the first vaccine administered then report the appropriate CPT “add-on” administration code (90472 or 90474) for each additional vaccine given on the same date of service. See also Question #2 above.
What is the admin CPT for intravenous injection?
When you bill IV hydration along with IV pushes, always report the IV push as the initial code. According to the CPT hierarchy, the initial code must be 96374. Following that code, 96361 must be assigned for the hydration.
Can you code 96372 twice?
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.
Can you bill 95117 and 96372 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 51 modifier for injections?
Modifier 51
When multiple procedures, other than Evaluation and Management (E/M), Physical Medicine and Rehabilitation services or provisions of supplies (e.g., vaccines) are performed at the same session by the same individual, the primary procedure or service may be reported as listed.
Can you bill 99213 and 20610 together?
Per CCI edits, CPT codes 20610-RT and 99213-25 cannot be billed together; however a modifier is allowed with supporting documentation.
Is CPT code 20610 considered surgery?
CPT code 20610 is used for a procedure where a healthcare provider drains fluid from or injects medication into a joint or bursa without using ultrasound guidance. This code typically applies to treatments for conditions like arthritis or bursitis to relieve pain and inflammation.
Does UHC cover CPT 96372?
A: Yes, UnitedHealthcare would reimburse for both the HCPCS drug code and the Injection or Infusion code (CPT 96360-96379) under the guidelines of this policy.
What is the difference between 96372 and 96401?
96372, therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular. 96401, chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic.