Wiki Cpt 96370

[Ksheon]

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

 

[Ksheon]

update

If anyone comes across this post wondering the same thing,

The edit "do not report more then once per encounter" for CPT code 96370 is actually a typo, so stated by Ingenix/Optum which is the CPT book which we use in the office. Ingenix sent me an email stating that this will be fixed prior to printing the 2014 CPT manual. It has also been confirmed through 3M customer service, that the only two edits for 96370 are; use 96370 in conjunction with 96369 and use 96370 for each additional hour of infusion after the initial 90 minutes.