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E&M vs Injection Administration

  1. Default E&M vs Injection Administration
    Medical Coding Books
    Looking for second opinion. A patient comes in for their B12 injection & that is all they want. However, the practice manager insists the nurses take their vitals so that they can be charged as a nurse only visit & collect their copay.

    I disagree with this method - does anyone else have an opinion. For me the Injection Admin code 96372 - represents the reason for the visit.

  2. #2
    Columbia, MO
    you cannot charge a 99211 just for vital signs when the patient comes in for a scheduled B12 injection. The taking of the vitals is part of the administration of the injection and is therefore part of the reimbursement for the 96372. You may not use a CPT code when a different CPT is the one that describes the service. So 96372 describe and injection administration encounter so that is what you must charge.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Smile Mona Tuccillo, CPC-A
    If you look on pg504 and read the guideline and also underneath the code where it says "Physicians don't report 96372for inj...." I believe you will find your answer right there.
    Also I have learned if the pt. has come for Schedule injection or some other service you can't charge for E&M code unless physician finds something else. I'm also agree with Mitchelle

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