Summary & Overview
CPT 96374: Intravenous Push Injection, Single or Initial Drug
CPT code 96374 represents the intravenous push administration of a single or initial therapeutic, prophylactic, or diagnostic substance or drug. This procedure is a cornerstone in acute and chronic care settings, enabling rapid delivery of medications for conditions such as chest pain, hypertension, and nausea. The code is widely recognized and reimbursed by major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare.
This publication provides a comprehensive overview of 96374, detailing its clinical context, typical sites of service, and its role within medicine services and procedures. Readers will gain insight into payer coverage, relevant policy updates, and benchmarks for utilization. The analysis also highlights associated clinical diagnoses and related CPT codes, offering a clear understanding of how 96374 fits into broader care pathways. With its frequent use in both hospital outpatient and office settings, understanding the nuances of this code is essential for healthcare professionals, administrators, and policy stakeholders seeking to optimize billing practices and ensure compliance with payer requirements.
CPT Code Overview
CPT code 96374 is used to report the administration of a therapeutic, prophylactic, or diagnostic injection via intravenous push, specifically for a single or initial substance or drug. This procedure falls under Medicine Services and Procedures and is commonly performed in both facility and office settings, such as hospital outpatient departments or physician offices. The code is typically reported under place of service codes POS 11 (Office) or POS 19–22 (Outpatient Hospital). Accurate coding of this service is essential for proper billing and reimbursement across a range of clinical scenarios.
Clinical & Coding Specifications
Clinical Context
A patient presents to a hospital outpatient department or physician office with symptoms such as chest pain, nausea with vomiting, or an acute exacerbation of chronic obstructive pulmonary disease. After evaluation, the provider determines that an intravenous medication is required for therapeutic, prophylactic, or diagnostic purposes. The provider or a qualified nurse administers a single or initial intravenous push of the specified substance or drug. The procedure is documented and coded as 96374. This workflow is typical for acute presentations requiring immediate medication delivery, such as antiemetics for nausea, antihypertensives for elevated blood pressure, or bronchodilators for COPD exacerbation.
Coding Specifications
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Modifier
25: Used when a significant, separately identifiable evaluation and management service is performed by the same physician or other qualified health care professional on the same day as the procedure or other service. This modifier distinguishes the E/M service from the injection procedure. -
Provider Taxonomies:
| Taxonomy Code | Specialty Name |
|---|---|
207RI0011X |