2025 CPT code 96368
Intravenous infusion, for therapy, prophylaxis, or diagnosis; concurrent infusion.
Modifiers may be applicable in certain situations. For distinct procedural services, modifier 59 may be appropriate.
Medical necessity must be established for both the initial and concurrent infusions. Documentation should clearly support the clinical rationale for administering the infusions.
The provider assesses the patient, discusses the need for the infusion, explains the procedure, and obtains consent. They verify medication, dosage, and administer the concurrent infusion via an established IV line, monitoring the patient throughout the process.
In simple words: The provider administers an intravenous infusion of additional medication(s) at the same time as another infusion, to treat, prevent, or diagnose a condition.This is not billed by itself, but along with the primary infusion.
This code represents the administration of a concurrent intravenous infusion, used for therapy, prophylaxis, or diagnosis. The substance or drug used should be specified. This is reported in addition to the primary procedure/infusion.
Example 1: A patient receiving a one-hour IV antibiotic infusion (96365) also needs concurrent IV hydration. 96368 is reported in addition to 96365., A patient with nausea related to chemotherapy receives a concurrent antiemetic infusion along with their scheduled chemotherapy. 96368 is reported in addition to the chemotherapy administration code., A patient requires an electrolyte infusion concurrently with their IV antibiotic treatment. 96368 is reported for the electrolyte infusion.
Documentation should include the name and dosage of all infused substances or drugs, start and stop times of each infusion, the reason for the concurrent infusion, patient monitoring details (vital signs, any adverse reactions), and medical necessity for the infusions.
** For facility reporting, an initial service code must accompany code 96368. The choice of the initial service code follows a hierarchy where chemotherapy is primary, followed by therapeutic, prophylactic, and diagnostic infusions, then hydration.
- Revenue Code: P6C
- Payment Status: Active
- Specialties:This code is commonly used by specialties that administer intravenous infusions, such as emergency medicine, internal medicine, oncology, and anesthesiology.
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office, Home, Skilled Nursing Facility, Nursing Facility, and other places of service where IV infusions are administered.