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Ask a Rev Cycle Expert: Code for Ketamine Infusion?


What would be the appropriate code(s) to use for billing related to a Ketamine Infusion for pain relief?


The answer is dependent upon the method of administration and possibly the duration of the infusion, as supported by the documentation in the medical record. Additionally, the administration should not be part of a surgical procedure, as pain relief is part of the surgical package.

For example, Current Procedural Terminology (CPT®) code 96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour may be used if the route of administration is intravenous (IV) infusion, and follow the infusion/injection hierarchy. Other possible administration codes include codes 62325-62370, or refilling and maintenance of a pain pump codes such as 95990-95991.

Disclaimer: This information was current at the time of its publishing and is designed to provide accurate information in regard to the subject matter covered. Vitalware does not accept any responsibility or liability with regard to any errors, omissions, misuses, or misinterpretation by the reader. It is not intended to take the place of either the written policies or regulations. We encourage you to review the specific regulations and other interpretive materials as necessary. All CPT® codes are trademarked by the American Medical Association (AMA) and all revenue codes are copyrighted by the American Hospital Association (AHA).