Ksheon
Contributor
How many times per encounter can this code be used? I was originally taught that if there is a 3 hour SC infusion, you would first code 96369 and then two units of 96370. However looking at this code in the CPT manual, it states, "Code First 96369, Do not report more then once per encounter."
I'm a little puzzled by this because CMS has a MUE when more then 3 units are billed and during most of my research today, insurance companies have maximum daily frequency limit for 96370 anywhere between 23 units to 8 units. It would seem to me if 96370 could only be used once per encounter the CMS MUE would be one unit, as well as the maximum daily allowances for most insurance companies.
Any information you could give would be greatly appreciated
I'm a little puzzled by this because CMS has a MUE when more then 3 units are billed and during most of my research today, insurance companies have maximum daily frequency limit for 96370 anywhere between 23 units to 8 units. It would seem to me if 96370 could only be used once per encounter the CMS MUE would be one unit, as well as the maximum daily allowances for most insurance companies.
Any information you could give would be greatly appreciated