Primary Care Coding Alert

Question: I’m having trouble finding a diagnosis code for 96372 when the physician administered two injections to treat the patient’s poison ivy and rash (benedryl and dexamethason). The reason for this is for a Benadryl injection (J1200), and a dexamethasone injection (J1100). What’s the solution?

Arizona Subscriber

Answer: Code 96372 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular) is the administration code for each of the two medications. You should also report J1200 (Injection, diphenhydramine HCL, up to 50 mg) and J1100 (Injection, dexamethasone sodium phosphate, 1 mg). The associated diagnosis is 692.6 (Contact dermatitis and other eczema; Due to plants [except food]); you’ll notice that poison ivy is one of the conditions listed as covered by the diagnosis.

Note: If you bill an office visit with 96372, append modifier 25 (Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service) to the E/M code. If you’re only billing the injections and medications and not a separate E/M service, you won’t need modifier 25. Also, don’t forget to bill 96372 twice or with two units of service, since you are administering two separate injections.