Summary & Overview
CPT 96373: Intra-Arterial Medication Administration
CPT code 96373 is a procedural billing code used for the intra-arterial administration of medications or substances, a technique employed to treat, prevent, or diagnose various medical conditions. This service is typically performed in an office setting and falls under the category of Nursing Services and Procedures. The code is relevant for a range of clinical scenarios where arterial access is necessary, such as managing chronic diseases or delivering targeted therapies.
Major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare recognize and reimburse for this code, making it a significant component of outpatient procedural billing. The publication provides an overview of payer coverage, clinical context, and related coding practices. Readers will gain insight into the procedural details, typical clinical indications, and how this code fits within broader office-based care. The summary also highlights associated modifiers and taxonomies, as well as common ICD-10 diagnoses linked to the procedure, offering a comprehensive view of its use in practice.
Key benchmarks, policy updates, and clinical context are discussed to inform stakeholders about the national landscape for CPT code 96373. The article is designed to support understanding of procedural coding, payer coverage, and clinical relevance for intra-arterial medication administration.
CPT Code Overview
CPT code 96373 describes the administration of a medication or other substance directly into an artery. This procedure is performed to treat, prevent, or diagnose a medical condition and is classified under Nursing Services and Procedures. The typical site of service for this code is the office setting (Place of Service 11). This code is commonly used in clinical scenarios where arterial access is required for effective delivery of therapeutic or diagnostic agents.
Clinical & Coding Specifications
Clinical Context
A patient with a chronic condition such as essential hypertension, type 2 diabetes mellitus, or chronic obstructive pulmonary disease presents to the office for ongoing management. During the visit, the provider determines that an intra-arterial injection of a medication or diagnostic substance is necessary to treat, prevent, or evaluate the patient's condition. The procedure is performed by a registered nurse or physician in the office setting (Place of Service 11), following standard protocols for arterial access and medication administration. The workflow includes patient assessment, preparation for arterial injection, administration of the substance, and post-procedure monitoring.
Coding Specifications
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Modifier
59: Distinct Procedural Service. Used when the intra-arterial injection (96373) is performed separately from other procedures, indicating it is not part of a bundled service. -
Modifier
51: Multiple Procedures. Applied when more than one procedure is performed during the same session, such as when96373is provided alongside other injections or services.
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