How To Use CPT Code 96374

CPT 96374 refers to the administration of a single medication or substance via intravenous push for therapeutic, prophylactic, or diagnostic purposes. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 96374.

1. What is CPT 96374?

CPT 96374 is a medical billing code used to describe the administration of a single medication or other substance rapidly into a vein for therapeutic, prophylactic, or diagnostic purposes. This code is used by medical coders and billers to accurately document and bill for this specific medical service.

2. 96374 CPT code description

The official description of CPT code 96374 is: “Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug.”

3. Procedure

1. The provider discusses the need for the rapid intravenous infusion with the patient and/or family member, explaining why it is necessary and what to expect.
2. The provider sets up the equipment and inserts the needle or catheter into the patient’s vein and connects it to the tubing. The provider may use an existing indwelling intravascular access catheter or port.
3. The provider compares the medication name and dosage on the label of the medication bag to the orders for the patient.
4. The provider then establishes the IV site and starts the infusion.
5. He sets the drip rate for a rapid infusion.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 96374 services are those who require a rapid intravenous infusion of a single medication or substance for therapeutic, prophylactic, or diagnostic purposes. This may include patients with acute or chronic medical conditions, those undergoing certain medical treatments, or those requiring diagnostic testing that involves the administration of a substance via intravenous push.

5. When to use CPT code 96374

It is appropriate to bill the 96374 CPT code when a single medication or substance is administered rapidly into a vein for therapeutic, prophylactic, or diagnostic purposes. This code should be used for the initial substance or drug administered during the encounter. If additional substances or drugs are administered during the same encounter, separate codes should be used to document those services.

6. Documentation requirements

Documentation supporting a claim for CPT 96374 should include the following information:

• Patient’s medical history and current condition
• Indication for the intravenous push administration
• Name, dosage, and route of administration of the substance or drug
• Start and stop times of the infusion
• Any adverse reactions or complications, if applicable
• Provider’s signature and credentials

7. Billing guidelines

When billing for CPT code 96374, it is important to follow the appropriate guidelines and rules to ensure accurate reimbursement. Some tips and guidelines include:

• Use the appropriate modifier if the service is performed in a facility setting.
• Ensure that the documentation supports the medical necessity of the service.
• Bill for additional substances or drugs administered during the same encounter using separate codes.
• Follow the hierarchy of infusion codes when reporting multiple administrations during the same encounter.

8. Historical information

CPT 96374 was added to the Current Procedural Terminology system on January 1, 2009. There have been no updates to the code since its addition.

9. Similar codes to CPT 96374

Five similar codes to CPT 96374 and how they differentiate are:

• CPT 96365: Describes an intravenous infusion for therapy, prophylaxis, or diagnosis for up to one hour for the initial drug.
• CPT 96366: Represents an intravenous infusion for therapy, prophylaxis, or diagnosis for each additional hour after the initial drug.
• CPT 96367: Refers to an additional sequential intravenous infusion of a new drug or substance.
• CPT 96368: Describes a concurrent intravenous infusion of a different substance or drug.
• CPT 96375: Represents an additional intravenous push of the same substance or drug provided in a separate encounter.

10. Examples

1. A patient with severe dehydration receives a rapid intravenous push of normal saline solution.
2. A patient undergoing chemotherapy receives a rapid intravenous push of a chemotherapy drug.
3. A patient with an acute asthma attack receives a rapid intravenous push of a bronchodilator medication.
4. A patient with a severe allergic reaction receives a rapid intravenous push of epinephrine.
5. A patient undergoing a diagnostic imaging study receives a rapid intravenous push of a contrast agent.
6. A patient with a severe infection receives a rapid intravenous push of an antibiotic medication.
7. A patient with uncontrolled hypertension receives a rapid intravenous push of an antihypertensive medication.
8. A patient with a severe migraine receives a rapid intravenous push of a pain-relief medication.
9. A patient with a life-threatening arrhythmia receives a rapid intravenous push of an antiarrhythmic medication.
10. A patient with severe electrolyte imbalance receives a rapid intravenous push of a potassium supplement.