Decipher the drug administration hierarchy, code for injections and infusions

March 27th, 2018

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains the structure of CPT drug administration reporting and why injection and infusion coding is often confusing for coders. It focuses on the hierarchy among drug administration service categories, the general distinctions among infusion, push, and injection services, and the documentation concepts that affect reporting. The piece is aimed at outpatient coding professionals, billing staff, and others who work with CPT drug administration services.

Why This Topic Matters

Correctly understanding drug administration hierarchy and related CPT guidance is important for accurate outpatient charge capture and compliant reporting of injection and infusion services. The article helps readers identify which general type of service is being documented and where the main coding challenges arise.

What You Will Learn

  • How CPT organizes drug administration services into broad categories
  • How the hierarchy affects reporting relationships among service types
  • What documentation elements are commonly reviewed for injections and infusions
  • Which general issues make IV push, infusion, and sequential/concurrent reporting challenging

Who Should Read This

  • Outpatient coding professionals
  • Medical billers
  • Revenue cycle staff
  • Compliance staff
  • Practice administrators

Codes Discussed

  • CPT: 96365
  • CPT: 96366
  • CPT: 96367
  • CPT: 96368
  • CPT: 96372
  • CPT: 96374
  • CPT: 96375
  • CPT: 96376
  • CPT: 96360
  • CPT: 96361

Code Ranges Discussed

  • CPT: 96401–96549
  • CPT: 96365–96379

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