How To Use CPT Code 96368

CPT 96368 describes the administration of intravenous infusion for therapy, prophylaxis, or diagnosis concurrently with another infusion. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 96368?

CPT 96368 can be used to describe the administration of intravenous infusion for therapy, prophylaxis, or diagnosis concurrently with another infusion. This code is used when multiple medications or substances are administered intravenously at the same time to prevent, treat, or diagnose a condition or disease.

2. Official Description

The official description of CPT code 96368 is: ‘Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); concurrent infusion (List separately in addition to code for primary procedure).’ This code should be reported only once per date of service and in conjunction with other primary procedure codes.

3. Procedure

1. The healthcare provider discusses the need for the intravenous infusion with the patient or their family member, explaining why it is necessary and what to expect.
2. The provider compares the medication name and dosage on the label of the medication bag to the orders for the patient.
3. The provider administers the intravenous infusion of a different drug concurrently with the initial infusion via an already established IV.
4. The provider sets the drip rate and starts the infusion, ensuring that both infusions are administered simultaneously.

4. Qualifying circumstances

CPT 96368 is used when the provider administers an intravenous infusion of multiple medications or substances concurrently with another infusion to prevent, treat, or diagnose a condition or disease. This code should be used when the infusion is for therapeutic, prophylactic, or diagnostic purposes.

5. When to use CPT code 96368

CPT code 96368 should be used when the provider administers an intravenous infusion concurrently with another infusion for therapy, prophylaxis, or diagnosis. This code should not be reported without an appropriate primary code, such as CPT codes 96365, 96366, 96413, 96415, or 96416.

6. Documentation requirements

To support a claim for CPT 96368, the healthcare provider must document the following information:

• The specific substance or drug used for the intravenous infusion
• Date and time of the infusion
• Start and end time of the concurrent infusion
• Details of the procedure, including the drip rate and any adjustments made
• Reason for the concurrent infusion and its therapeutic, prophylactic, or diagnostic purpose
• Signature of the healthcare provider administering the infusion

7. Billing guidelines

When billing for CPT 96368, ensure that the concurrent infusion is performed by a qualified healthcare provider. This code should be listed separately in addition to the primary procedure code. Modifier 25 should be appended to the associated E/M code if the provider performs an evaluation and management service on the same day as the infusion. It is important to select the appropriate primary code based on the purpose of the infusion and to follow the hierarchy for reporting infusion codes.

8. Historical information

CPT 96368 was added to the Current Procedural Terminology system on January 1, 2009. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider administers an intravenous infusion of antibiotics concurrently with an infusion of fluids for a patient with a severe infection.
2. A nurse administers an intravenous infusion of pain medication concurrently with an infusion of anti-nausea medication for a patient undergoing chemotherapy.
3. A physician administers an intravenous infusion of contrast dye concurrently with an infusion of saline solution for a patient undergoing a diagnostic imaging procedure.
4. A healthcare provider administers an intravenous infusion of immunoglobulins concurrently with an infusion of corticosteroids for a patient with an autoimmune disorder.
5. A nurse administers an intravenous infusion of anticoagulant medication concurrently with an infusion of blood products for a patient with a bleeding disorder.
6. A physician administers an intravenous infusion of chemotherapy drugs concurrently with an infusion of antiemetic medication for a patient with cancer.
7. A healthcare provider administers an intravenous infusion of antibiotics concurrently with an infusion of antifungal medication for a patient with a severe fungal infection.
8. A nurse administers an intravenous infusion of pain medication concurrently with an infusion of sedative medication for a patient undergoing a surgical procedure.
9. A physician administers an intravenous infusion of contrast dye concurrently with an infusion of saline solution for a patient undergoing a cardiac catheterization.
10. A healthcare provider administers an intravenous infusion of immunosuppressant medication concurrently with an infusion of hydration fluids for a patient undergoing an organ transplant.