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Thread: 90772 changed to 96372 for 2009

  1. #1

    Default 90772 changed to 96372 for 2009

    AAPC: Back to School
    I have a question in reguards to the description on these codes. It says that this code should NOT be billed without "direct physician supervision". Does this mean that the physician has to be in the exam room while the nurse gives the injection or does it mean he has to be in the building?
    Anita Hudson, CPC
    Scott and White Bryan/College Station

  2. #2

    Smile senior biller

    no they do not have to be present in the room, phy in attendance in the office is how I understant the code.

  3. #3


    I have a question about 90772 being changed to 96372.... Have you sumitted the new code to insurance carriers yet??? Medicare is not recongizing it...Does Physican have to be in the room??

    Thanks for your help!!

  4. #4
    Join Date
    Apr 2007
    Greeley, Colorado


    I have not seen it come across my desk. Direct physician supervision simply means that the physician is in the office suite...not in the exam room.
    Lisa Bledsoe, CPC, CPMA

  5. #5


    I have billed the new 96372 and medicare is recognizing for us. It was effective 1/1/09, so if you have used it for DOS prior to that, then it will deny.

  6. #6

    Default 96372

    I got an eob yesterday and Medicare denied 96372 on my patient. DOS was 01-09-09 we are an Instant care center. Place of service 20. Do you guys think the POS has something to do with it???

    update: Per Medicare's CSR 96372 cannot be used in a 20 place of service. Does anyone know where that is written?


    Last edited by jhancock; 01-23-2009 at 09:31 AM.

  7. #7
    Join Date
    Apr 2007
    cherry hill nj

    Default im injection multiple times

    Help, If an IM of demoral was admin twice and a 3rd IM of rocephin, how many times can i code 96372?

  8. #8

    Default 96372 ...which medicare carriea paid?

    Hi Angela. To which Medicare(region) you billed 96372???
    I assum they paid you instanlty as they were 90772 in 2008. We had no problem w/90772.
    Our medicare carrier, Palmetto GBA, said need modifier 25
    even with the E/M code we appended 25 modifer.
    They said everything stated in Publication 100-04 CMP 12
    section 34??? I check 100-04 nothing said.
    Even I was told to check CR3192, CR3631, CR3818 & CR4032 (CR means "change request" per Palmetto), cannot find anything.
    Could anyone give us the clear answer?

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