Sunday, February 27, 2011

CPT 96372: Getting Additional Reimbursement for Intramuscular Injections With Code

Whether you are providing patients with antibiotics, B-12 shots or other intramuscular injects, many physicians do not realize that significant revenue can be generated by providing these services in the office. Many providers miss out on this source of income because they are not familiar with how to properly code for these services. For example, if you give your patient an injection of antibiotics, you may simply have the nurse administer the injection. If, however, you are on hand during the injection process you can generate as much as $20.30 for each patient who receives this injection in your office.

Making the Most of CPT 96372

Many physicians overlook the fact that additional revenue can be captured for intramuscular injections. The amount generated by these services can be over and above the other procedures performed in the office. While some doctors do bill for these services, many do not list the codes on the claim forms properly. For example, if you have more than four procedure codes listed on the claim form, the insurance company will only have to consider the first for. Because of this, you should ensure that the most expensive procedures are listed in the first four positions on the claim forms that you submit to the insurance providers.

When you bill for injectable medication, you will also need to use a diagnosis code that corresponds to the medication being administered. For example, if you are providing your patient with a B-12 shot due to a vitamin deficiency, then you should use the appropriate diagnosis code when submitting the claim forms. Be as specific as possible when using diagnosis codes in order to maximize the revenue generated for your practice.

While CPT 96372 can be used for many intramuscular injections, it is important to remember that you cannot use this code for every injection you administer. For example, when providing your patients with flu shots, you will need to use the administration code in addition to the vaccine code. You cannot use CPT 96372 to bill for injections that have their own corresponding CPT code.

Weighing the Costs of Injectable Medication

Providing patients with intramuscular injections is not a cost-free endeavor. You must pay for the injectable medication as well as the syringes, alcohol swabs and dressings. When you do not bill for the intramuscular injections you provide, you are losing money on the supplies that are required to provide these injections to your patients. If you do not want to lose money each time your office administers an intramuscular injection, you need to make use of the billing codes that will allow you to obtain proper reimbursement from the insurance companies.

It is not uncommon for medical practice managers to spend significant amounts of time trying to find low-cost syringes and injectable medications at discount prices. Oftentimes price breaks are only possible when ordering vials of medication in bulk. If you do not bill properly when providing your patients with these medications, you are losing money with each injection your practice administers.

If you want to maximize your practice's revenue, make sure you use code CPT 96372 whenever possible. When you realize just how much revenue your practice can generate, you may even decide to expand the number of injectable medications that you keep on hand for your patients.


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  3. As Bundel says, you can often get paid more for the administration then for the medication itself. But please do remember to use modifier 59 on the 96372 and modifier 25 on the office visit. We have had a few denials.

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  5. How much do you bill insurance for this code?


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