Health Information Management

Q/A: Reporting code 96372 for one dose administered via two injections

APCs Weekly Monitor, September 5, 2009

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Q. A physician orders one dose of a medication to be administered intramuscularly (IM) or subcutaneously (SQ). The volume required for this dose exceeds the amount recommended for a single injection, so the nurse must divide the dose into two IM/SQ injections. May we report one or two units of CPT code 96372 to report this service? Do you know the maximum number of units with the same date of service that providers may report to Medicare? We experience edits when we report this procedure with multiple units.  
 
A: Report the multiple IM/SQ injections with 96372 (therapeutic, prophylactic or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular) with the number of injections administered to the patient. Although medically unlikely edits (MUEs) exist for other drug administration codes, CMS has not published MUE limits for 96372.



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