CPT® Code 96372 is used to report the administration of a therapeutic, prophylactic, or diagnostic injection delivered either intramuscularly (IM) or subcutaneously (SubQ) by a qualified healthcare professional.
Overview
This code applies when a provider (typically a nurse or medical assistant under supervision) administers a medication or substance by injection, but not as part of an infusion or vaccine-specific protocol. Commonly administered drugs include antibiotics, steroids, B12, Toradol, and anti-nausea or migraine medications.
It is not used for vaccines or chemotherapy, which have separate codes.
Typical Patient Description
A patient arrives at the clinic for a B12 injection to treat fatigue and low energy. The medical assistant verifies the order, confirms the dose, administers the injection intramuscularly, and documents the administration and patient response.
Alternatively, a patient experiencing acute pain is prescribed Toradol (ketorolac) for relief, which is given via intramuscular injection during the office visit.
Care Components
- Provider-administered injection: Medication is administered by licensed personnel; self-administration by the patient does not qualify.
- Injection technique: Proper use of SubQ or IM injection technique is critical.
- Documentation: The provider must document the drug name, dose, site of administration, route, reason for use, and patient response.
- Separate reporting from office visit: If done during an E/M visit (e.g., 99213), Modifier 25 may be required on the E/M code to indicate the injection is a separately identifiable service.
Billing Considerations
- 96372 covers only the injection procedure, not the drug itself — the medication must be billed separately using its HCPCS or J-code.
- Time-based rules do not apply: Unlike infusions or therapies, this code is event-based.
- Do not bill with vaccine administration codes: Vaccinations have separate CPT codes, such as 90471 or 90472.
Using CPT 96372 in OptiMantra
Within OptiMantra, healthcare practices can efficiently manage injection-related documentation and billing:
- Medication charting templates: Support the recording of drug name, dose, site, route, and lot number.
- Automated charge capture: Link 96372 to pre-configured treatment types for seamless billing.
- Inventory tracking: For in-office administered drugs, OptiMantra can track inventory and ensure accurate charge posting.
- Claim compliance: The system allows easy addition of HCPCS/J-codes and modifiers, helping ensure clean claims and minimize rejections.
By utilizing OptiMantra’s integrated tools, clinics can streamline the delivery, documentation, and billing of injection services like 96372, improving efficiency and reimbursement accuracy.
Try OptiMantra for free here!
