2025 CPT code 96376
Each additional sequential intravenous push of the same substance/drug provided in a facility.
Modifier 59 may be appended to indicate a distinct procedural service.
Medical necessity is established by documenting the clinical rationale for each sequential IV push of the same substance/drug and demonstrating the patient's continued need for the administered drug beyond the initial injection within the same encounter.
The provider discusses the need for an additional rapid intravenous infusion with the patient and/or family member, explaining why it is necessary and what to expect. When the patient is appropriately prepped, the provider examines the previously established site. They compare the name and dosage on the label of the drug to the patient’s orders. The provider then prepares the same substance or drug and rapidly administers the drug or substance via IV push into the vein.
In simple words: After an initial injection of a drug or other substance via intravenous, or IV, push, the provider sequentially injects the same medication or substance for prevention, diagnosis or for therapeutic purposes.
Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (List separately in addition to code for primary procedure)Notes: (Do not report 96376 for a push performed within 30 minutes of a reported push of the same substance or drug)(96376 may be reported by facilities only)(Report 96376 in conjunction with 96365, 96374, 96409, 96413)
Example 1: A patient in the emergency room requires a second IV push of the same antiemetic medication due to continued nausea after the initial dose., A patient undergoing a procedure in an ambulatory surgical center needs an additional dose of the same sedative through IV push., A hospitalized patient receiving pain medication via IV push requires a second dose of the same analgesic before being discharged.
Documentation must specify the name of the drug, dosage, time of administration for each push, and the clinical indication for the additional injection. The time elapsed since the previous push of the same substance must also be documented to justify use of 96376.
** Code 96376 is not intended to be reported by providers in physician offices, only facilities.
- Revenue Code: P6C
- Specialties:Emergency Medicine, Anesthesiology, Hospitalists, various specialties depending on clinical scenario
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center, Emergency Room - Hospital, Other Place of Service