Getting denied for injection administration can be common. How to make sure you get paid.
Question: At times, we are getting denials for our injection administration.Can you give us guidance as to how to bill these correctly?
Answer: Across the country, in offices and facilities, coders are having trouble with CPT 96372 - Therapeutic, prophylactic, or diagnostic injection, specify substance, or drug; subcutaneous or intramuscular.
The primary intent of an injection as described by 96372 is generally to deliver a small volume of medication in a single shot subcutaneous (sub-Q), intramuscular (IM), or intra-arterial (IA) routes, as opposed to an intravenous (IV) injection/push that requires a commitment of time. 96372 CPT code reimbursement is allowed when the injection is performed alone or in conjunction with other procedures/services as allowed by the National Correct Coding Initiative (NCCI).
Separate reimbursement will not be allowed for CPT code 96372 when billed in conjunction with an Evaluation and Management (E/M) Service (CPT code 99201-99499) by the same rendering provider on the same date of service.
As 96372 is applied incorrectly, providers are not being paid for this injection administration code. Here are some things to keep in mind when billing this code:
Renee Dowling is a compliance auditor for Sansum Clinic, LLC, in Santa Barbara, California.