How To Use CPT Code 96375

CPT 96375 is a code used for billing additional sequential intravenous push of a new substance or drug during therapeutic, prophylactic, or diagnostic injections. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT code 96375 procedures.

1. What is CPT 96375?

CPT 96375 is a medical billing code used to describe the administration of an additional sequential intravenous (IV) push of a new substance or drug during therapeutic, prophylactic, or diagnostic injections. This code is used when a healthcare provider administers multiple substances or drugs sequentially via IV push for prevention, diagnosis, or treatment purposes.

2. 96375 CPT code description

The official description of CPT code 96375 is: “Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure)”.

3. Procedure

1. The healthcare 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 compares the medication name and dosage on the label of the medication bag to the orders for the patient.
3. The provider adds the additional prepackaged medication of a different drug from the initial infusion to an already established IV and sets the infusion rate.
4. He then rapidly administers the drug or substance into a vein by IV push.
5. The provider uses the same technique to infuse one or more additional drugs sequentially.

4. Qualifying circumstances

Patients who require multiple substances or drugs to be administered sequentially via IV push for prevention, diagnosis, or treatment purposes are eligible to receive CPT code 96375 services. The healthcare provider must determine the necessity of administering additional substances or drugs and ensure that the patient meets the appropriate criteria for receiving these services.

5. When to use CPT code 96375

It is appropriate to bill the 96375 CPT code when a healthcare provider administers an additional sequential intravenous push of a new substance or drug during therapeutic, prophylactic, or diagnostic injections. This code should be used in conjunction with the primary procedure code for the initial substance or drug administration.

6. Documentation requirements

To support a claim for CPT 96375, the healthcare provider must document the following information:

• Name of the drug or substance administered
• Dosage and route of administration
• Time and duration of the infusion
• Medical necessity for the additional sequential IV push
• Any adverse reactions or complications

7. Billing guidelines

When billing for CPT code 96375, it is important to follow the appropriate guidelines and rules. This code is an add-on code and should be billed in addition to the primary procedure code for the initial substance or drug administration. Some primary codes that can be used in conjunction with CPT 96375 include 96365, 96374, 96409, and 96413. Additionally, the documentation for all infusion codes must specify the name of the drug or substance being administered.

8. Historical information

CPT 96375 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 96375

Five similar codes to CPT 96375 and how they differentiate are:

• CPT 96365: Describes the initial intravenous infusion for therapy, prophylaxis, or diagnosis, up to one hour.
• CPT 96374: Describes the initial intravenous push of a single or initial substance or drug.
• CPT 96409: Describes the administration of chemotherapy via intravenous push technique, single or initial substance or drug.
• CPT 96413: Describes the administration of chemotherapy via intravenous infusion technique, up to one hour, single or initial substance or drug.
• CPT 96360: Describes the initial hour of intravenous hydration infusion.

10. Examples

1. A patient receives an initial IV push of an antibiotic, followed by a sequential IV push of an antiemetic drug. CPT 96375 would be billed for the administration of the antiemetic drug.
2. A patient undergoing chemotherapy receives an initial IV push of a chemotherapy drug, followed by a sequential IV push of a different chemotherapy drug. CPT 96375 would be billed for the administration of the second chemotherapy drug.
3. A patient receives an initial IV infusion of a therapeutic drug for one hour, followed by a sequential IV push of a different drug. CPT 96375 would be billed for the administration of the second drug.
4. A patient receives an initial IV push of a diagnostic agent, followed by a sequential IV push of a different diagnostic agent. CPT 96375 would be billed for the administration of the second diagnostic agent.
5. A patient receives an initial IV push of a prophylactic drug, followed by a sequential IV push of a different prophylactic drug. CPT 96375 would be billed for the administration of the second prophylactic drug.
6. A patient receives an initial IV push of a pain medication, followed by a sequential IV push of an anti-inflammatory drug. CPT 96375 would be billed for the administration of the anti-inflammatory drug.
7. A patient receives an initial IV push of a sedative, followed by a sequential IV push of a different sedative. CPT 96375 would be billed for the administration of the second sedative.
8. A patient receives an initial IV push of a muscle relaxant, followed by a sequential IV push of a different muscle relaxant. CPT 96375 would be billed for the administration of the second muscle relaxant.
9. A patient receives an initial IV push of a vasopressor, followed by a sequential IV push of a different vasopressor. CPT 96375 would be billed for the administration of the second vasopressor.
10. A patient receives an initial IV push of an anticoagulant, followed by a sequential IV push of a different anticoagulant. CPT 96375 would be billed for the administration of the second anticoagulant.