How To Use CPT Code 96379

CPT 96379 describes the administration of therapeutic, prophylactic, or diagnostic intravenous or intra-arterial injections or infusions that do not have a specific code. 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 96379?

CPT 96379 can be used to report therapeutic, prophylactic, or diagnostic intravenous or intra-arterial injections or infusions that do not have a specific code. This code is used when the procedure performed by the healthcare provider does not have a specific code available in the Current Procedural Terminology system.

2. Official Description

The official description of CPT code 96379 is: ‘Unlisted therapeutic, prophylactic, or diagnostic intravenous or intra-arterial injection or infusion.’

3. Procedure

1. The healthcare provider performs a therapeutic, prophylactic, or diagnostic intravenous or intra-arterial injection or infusion procedure that does not have a specific code available.
2. The procedure may be performed for treatment purposes (therapeutic) or for the prevention of a disease or condition (prophylactic).
3. The injection or infusion may be administered through a syringe or via vein access, depending on the specific needs of the patient.
4. The procedure may be performed to determine the type of disease and its causes (diagnostic).

4. Qualifying circumstances

CPT 96379 is used when the healthcare provider performs a therapeutic, prophylactic, or diagnostic intravenous or intra-arterial injection or infusion procedure that does not have a specific code available. This code is used when there is no other appropriate code to accurately describe the procedure performed.

5. When to use CPT code 96379

CPT code 96379 should be used when the healthcare provider performs a therapeutic, prophylactic, or diagnostic intravenous or intra-arterial injection or infusion procedure that does not have a specific code available. This code should only be used when there is no other appropriate code that accurately describes the procedure performed.

6. Documentation requirements

To support a claim for CPT 96379, the healthcare provider must document the following information:

• A detailed description of the procedure performed
• The reason for choosing the unlisted code instead of a defined, active code
• Comparison to similar codes to justify the claim amount
• Operative notes or other relevant documentation to strengthen the claim

7. Billing guidelines

When billing for CPT 96379, ensure that the procedure performed does not have a specific code available. Use the unlisted procedure code only when there is no other appropriate code that accurately describes the procedure. Include a cover letter explaining the reason for choosing the unlisted code and provide supporting documentation to avoid a possible denial.

8. Historical information

CPT 96379 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 injection of a medication that does not have a specific code available.
2. A patient receives an intra-arterial infusion for diagnostic purposes, and there is no specific code for the procedure performed.
3. A therapeutic intravenous infusion is performed using a substance that does not have a specific code available.
4. A healthcare provider administers a prophylactic intravenous injection to prevent a specific disease, and there is no specific code for the procedure performed.
5. An unlisted therapeutic intravenous infusion is performed for a patient with a complex medical condition, and there is no specific code available to accurately describe the procedure.
6. A diagnostic intra-arterial injection is performed to determine the cause of a patient’s symptoms, and there is no specific code for the procedure performed.
7. A healthcare provider administers an intravenous infusion of a medication that is not covered by any specific code.
8. An unlisted prophylactic intravenous injection is performed to prevent a specific condition, and there is no specific code available for the procedure.
9. A therapeutic intra-arterial infusion is performed using a substance that does not have a specific code available.
10. A diagnostic intravenous injection is performed to determine the type of disease affecting a patient, and there is no specific code for the procedure performed.