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A therapeutic, prophylactic, or diagnostic injection refers to the administration of a specified substance or drug through an intravenous push (IVP) technique. This method involves using a syringe to inject the substance directly into an injection site of an existing intravenous line or an intermittent infusion set, commonly known as a saline lock. The injection is typically delivered over a short duration, usually less than 15 minutes, allowing for rapid administration of the medication. In the context of coding, CPT® Code 96376 is specifically designated for each additional sequential intravenous push of the same substance or drug when performed in a facility setting. It is important to note that this code is used in conjunction with other related codes: CPT® Code 96374 is utilized for the initial or single administration of a substance or drug, while CPT® Code 96375 serves as an add-on code for each additional sequential push of a new substance or drug through the same venous access site. The use of CPT® Code 96376 is applicable when the interval between each administration of the same substance or drug is 30 minutes or more, ensuring proper billing and documentation for the services rendered.
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The indications for the use of CPT® Code 96376 include scenarios where a therapeutic, prophylactic, or diagnostic injection is necessary. This may involve the administration of medications for various medical conditions that require immediate intervention or ongoing treatment. The specific indications can include, but are not limited to:
The procedure for administering an intravenous push (IVP) using CPT® Code 96376 involves several key steps that ensure the safe and effective delivery of the specified substance or drug. These steps include:
Post-procedure care following the administration of an intravenous push using CPT® Code 96376 involves several considerations. Patients should be observed for any adverse reactions to the medication administered, which may include allergic responses or side effects. Documentation of the procedure, including the substance or drug used, dosage, and the time interval between administrations, is essential for accurate billing and compliance. Additionally, patients may receive instructions regarding any follow-up care or monitoring that may be necessary based on the substance administered and their overall health status. It is also important to ensure that the intravenous access site remains patent and free from complications such as infiltration or phlebitis.
| Short Descr | TX/PRO/DX INJ SAME DRUG ADON | Medium Descr | THER PROPH/DX NJX EA SEQL IV PUSH SBST/DRUG FAC | Long Descr | Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (List separately in addition to code for primary procedure) | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 0 | CCS Clinical Classification | 231 - Other therapeutic procedures |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 96365 | MPFS Status: Active Code APC S CPT Assistant Article 1Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour | 96374 | MPFS Status: Active Code APC S CPT Assistant Article 1Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug | 96409 | MPFS Status: Active Code APC S Physician Quality Reporting PUB 100 CPT Assistant Article 1Chemotherapy administration; intravenous, push technique, single or initial substance/drug | 96413 | MPFS Status: Active Code APC S Physician Quality Reporting PUB 100 CPT Assistant Article 1Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GW | Service not related to the hospice patient's terminal condition | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2011-01-01 | Changed | Short description changed. |
| 2009-01-01 | Added | - |