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).
What is the CPT code for prophylaxis?
CPT® Code 96372 – Therapeutic, Prophylactic, and Diagnostic Injections and Infusions (Excludes Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration) – Codify by AAPC
When to not report E/M code 96379?
Do not report 96365-96379 with any codes that describe a procedure of which IV push or infusion are a part. Hospitals may not report an E/M code in addition to 96372 or 96373 when the sole purpose of the visit is drug administration. This guidance should resolve any problems you were having with 96372.
Can I report 99211 and 96372 at the same time?
Bottom Line: Insurance payers are not paying 99211 when reported on the same date of service as 96372. If you report these codes in combination, the payer will deny the claim.
Does peerpeach state health plan cover CPT 96372 (therapeutic administration fee)?
Peach State Health Plan will provide reimbursement for CPT 96372 (Therapeutic Administration Fee) only when reporting Synagis® injection and Depo-Provera Injection.
Does the CPT code 99381 need a modifier?
The Preventive Medicine codes (99381-99412, 99429) do not need Modifier 25 to indicate a significant, separately identifiable service when reported in addition to the diagnostic and therapeutic Injection service. The Preventive Medicine codes include routine services such as the ordering of immunizations or diagnostic procedures.
