Ask a Rev Cycle Expert: Infusion and Injection Charges?
Patient has Benadryl® intravenous push (IVP) and TYLENOL® per os (p.o.) ordered to be given pre-transfusion as part of blood administration protocol. Should they be charged for injection for the Benadryl? Also, if medications Benadryl and Pepcid® are given for an allergic reaction (rash) during the infusion, can you charge for 96374 and 96375 for injections?
When a medication is given as part of a protocol, it is generally not charged because medical necessity has not been established. When medication is given due to a clinical indication, such as an allergic reaction during the infusion, then you may report the Current Procedural Terminology (CPT®) codes for the infusion or injection based on the infusion and injection hierarchy.
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).