Oncology & Hematology Coding Alert

Reader Questions:

Skip +96376 on Physician Claim

Question: If I code for the physician, am I supposed to report +96376 for services that are in the facility instead of in an office? Missouri Subscriber Answer: No. Only the facility should report +96376 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; each additional sequential intravenous push of the same substance/drug provided in a facility [List separately in addition to code for primary procedure]). CPT includes a crucial parenthetical note under +96376 to keep physician coding on the straight and narrow: "(96376 may be reported by facilities only)." Tip: Code +96376 is status "X" in the physician fee schedule. This means: "Statutory Exclusion. These codes represent an item or service that is not in the statutory definition of 'physician services' for fee schedule payment purposes. No RVUs or payment amounts are shown for these codes, and no payment may be made under the physician fee schedule," according to [...]
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