Wiki 96372 administration code HELP

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rsearcy3

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I have a question about the administration code for an injection. One of my billers stated that we needed to add this code to our claims and I have been trying to find the answer. In our practice we give antibiotic and steroid injections quiet often as we are a family practice and they are wanting us to add this code to the bill. I feel that this is part of the E/M code and it should be included. I have seen many discussions on this and some say add a modifier 25 to the E/M code, but for this reason I hesitate. Can someone please help me with this?
 
Thank you for your response. They are actually coming in as an established visit for sickness. They are not schedule for injection, but the provider decides to give the patient an injection for the sickness.
 
Injections are reported separately

rsearcy3 said:
I have a question about the administration code for an injection. One of my billers stated that we needed to add this code to our claims and I have been trying to find the answer. In our practice we give antibiotic and steroid injections quiet often as we are a family practice and they are wanting us to add this code to the bill. I feel that this is part of the E/M code and it should be included. I have seen many discussions on this and some say add a modifier 25 to the E/M code, but for this reason I hesitate. Can someone please help me with this?
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Yes you should be reporting the subcutaneous and intramuscular injections when provided in a physician's office. These are valued only for the physician's supervision, practice expense, and liability and are separate from the physician's E/M service. You will need to add a modifier 25 to any E/M service reported on the same date when a significant and separately identifiable E/M service is rendered. As previously noted, there should be no E/M charged for encounters that are solely for an injection. You also cannot charge a 99211 service in conjunction with 96372.

The NCCI policy manual for Medicaid explains this well. "Although CPT code 99211 is not reportable with chemotherapy and non-chemotherapy drug/substance administration HCPCS/CPT codes, other non-facility based evaluation and management CPT codes (e.g., 99201-99205, 99212-99215) are separately reportable with modifier 25 if the physician provides a significant and separately identifiable E&M service."

Hope that helps.
Cindy
 
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