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Coding for Psychotropic Meds by Injection

  1. Default Coding for Psychotropic Meds by Injection
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    I recently was handed responsibility for a mental health practice with a growing list of outpatient clients.

    The coding / billing is pretty straightforward, but I could use some help in a couple of areas.

    There are two psychiatrists who handle the med management for patients; they frequently have injections administered by nurses on staff. They currently are not billing for these, and I am having difficulty determining how (or if) it should be done.

    The billing is almost exclusively Medicaid, although they will soon be expanding to Medicare and privately insured patients. Practice is located in North Carolina.

    Anyone familiar with this area?

    Any info would be greatly appreciated.


  2. #2
    Code 96372 comes top mind for the admin (Therapeutic, prophylactic, or diagnostic injection (specify substance or drug);subcutaneous or intramuscular)

    CPT cautions not to report 96372 without direct physician supervision, which according to CMS means the physician doesn't have to be in the room at the time of the injection, but immediately available in the office suite.

  3. Default Reference inquiry

    Thanks for the input; I was considering the same code, but I couldn't determine what the rules were for "direct physician supervision".

    Where did you find the CMS definition, or is this just from experience?

    Thanks again.

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