Neurology & Pain Management Coding Alert

Question: Our provider split a vial of medication and administered it to the patient at two different sites. We know to submit CPT 96372 for the injection. How do we handle everything else -- with modifiers, two administration codes? Missouri Subscriber Answer: You can report 96372 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular) for each individual injection because your provider administered the medication to two distinct sites. How you list the injections on the claim depends on the exact situation. Scenario 1: If the provider performed both injections for the same reason (that is, linked to the same diagnosis code), report the injections as a single line item with two units of service. Scenario 2: If the provider administers injections of the same drug at different anatomic locations for different diagnoses (different ICD-9 codes), report the injection codes on separate line items so that each 96372 [...]