How To Use CPT Code 96371

CPT 96371 describes the procedure for subcutaneous infusion for therapy or prophylaxis, specifically the additional pump set-up with the establishment of new subcutaneous infusion site(s). This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 96371?

CPT 96371 can be used to describe the additional pump set-up with the establishment of new subcutaneous infusion site(s) for subcutaneous infusion therapy or prophylaxis. This code is used when a healthcare provider inserts a catheter just under the patient’s skin in a different location than the previously established site, and sets up an infusion pump to administer medication or substances for prevention or therapeutic purposes.

2. Official Description

The official description of CPT code 96371 is: ‘Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); additional pump set-up with establishment of new subcutaneous infusion site(s) (List separately in addition to code for primary procedure).’ This code is an add-on code and must be accompanied by a code for the primary procedure.

3. Procedure

  1. The healthcare provider prepares the patient and inserts a catheter just under the patient’s skin in a new location.
  2. The provider verifies the dosage of the medication or substance to be infused and compares it to the patient’s orders.
  3. The provider prepares the substance for infusion and loads it into an infusion pump or syringe driver.
  4. The provider sets the appropriate infusion rate for delivery.

4. Qualifying circumstances

CPT 96371 is used when a healthcare provider establishes a new subcutaneous infusion site(s) and sets up an infusion pump for therapy or prophylaxis. This code is used for the administration of medication or substances below the skin for prevention or therapeutic purposes.

5. When to use CPT code 96371

CPT code 96371 should be used when a healthcare provider performs the additional pump set-up with the establishment of new subcutaneous infusion site(s) for subcutaneous infusion therapy or prophylaxis. This code should be used in addition to the primary procedure code.

6. Documentation requirements

To support a claim for CPT 96371, the healthcare provider must document the following information:

  • The specific substance or drug used for the infusion
  • Date and time of the procedure
  • Details of the new subcutaneous infusion site(s) established
  • Documentation of the pump set-up
  • Infusion rate and duration

7. Billing guidelines

When billing for CPT 96371, ensure that the procedure involves the additional pump set-up with the establishment of new subcutaneous infusion site(s). This code should be reported in addition to the primary procedure code. It is important to use the appropriate primary code, such as CPT code 96369 for the initial hour of subcutaneous infusion therapy or prophylaxis. Do not report CPT 96371 without an appropriate primary code.

8. Historical information

CPT 96371 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 establishes a new subcutaneous infusion site and sets up an infusion pump for the administration of pain medication for a patient with chronic pain.
  2. A nurse inserts a catheter just under the patient’s skin in a different location and sets up an infusion pump to administer antibiotics for a patient with an infection.
  3. A physician prepares a substance for infusion, loads it into an infusion pump, and establishes a new subcutaneous infusion site for the administration of a medication to prevent blood clots in a patient at risk.
  4. A healthcare provider sets up an infusion pump and establishes a new subcutaneous infusion site to administer a medication for the treatment of a chronic condition in a patient.
  5. A nurse verifies the dosage of a medication, prepares it for infusion, and sets the appropriate infusion rate for delivery through a newly established subcutaneous infusion site.
  6. A healthcare provider inserts a catheter just under the patient’s skin in a different location and sets up an infusion pump to administer a medication for the management of a patient’s symptoms.
  7. A nurse prepares a substance for infusion, loads it into an infusion pump, and establishes a new subcutaneous infusion site for the administration of a medication to prevent an allergic reaction in a patient.
  8. A healthcare provider sets up an infusion pump and establishes a new subcutaneous infusion site to administer a medication for the treatment of a patient’s chronic disease.
  9. A nurse verifies the dosage of a medication, prepares it for infusion, and sets the appropriate infusion rate for delivery through a newly established subcutaneous infusion site.
  10. A healthcare provider inserts a catheter just under the patient’s skin in a different location and sets up an infusion pump to administer a medication for the management of a patient’s symptoms.

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