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Thread: 96373--How many times can you code?

  1. #1
    Join Date
    Apr 2007

    Default 96373--How many times can you code?

    AAPC: Back to School
    Is it appropriate to bill out 96373 multiple times during a procedure for the same drug being given multiple times? I have been researching this all day and there seems to be little information on whether or not this can be done. Here is an example situation of drugs administered during a cath lab procedure, lets just say all these drugs listed are billable (since I know this may vary from place to place):

    Procedure Start Time: 11:26 AM
    Procedure End Time: 12:03 PM

    11:42 AM: 200 mcg Nitro IC
    11:34 AM: 9 ml Integrilin Bolus IV
    11:47 AM: 6 ml per hr Integrilin Infusion IV
    11:53 AM: 200 mcg Nitro IC

    Here is what I would currently code:
    96373: Nitro IC at 11:42
    96375: Integrilin Bolus IV at 11:34
    96365: Integrilin Infusion at 11:47

    So my question is, do I charge for the second Nitro IC at 11:53?

  2. #2
    Join Date
    Apr 2007

    Talking Billing for Chemotherapy Drug Administration

    Only one initial code is allowed per patient encounter unless two separate IV sites are medically reasonable and necessary (use modifier 59). If the patient returns for a separate and medically reasonable and necessary visit (encounter) on the same day, another initial code may be billed for that visit with modifier 59.

    Remember chemotherapy is billed by the time not the drug or how many times the drug was used.

    In your case, how you would currently code is correct and no you would not count the second Nitro IC at 11:53.

    I hope this helps, here are two links that can sometimes be helpful, also always review the CMS website: https://www.noridianmedicare.com/pro...cs/MR_FAQs.pdf

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