CPT® Code 96379 is used to report a therapeutic, prophylactic, or diagnostic intravenous (IV) or intra-arterial (IA) injection or infusion service that is not specifically described by another CPT® code. This unlisted procedure code is reserved for medically necessary injection or infusion services that cannot be accurately reported using existing administration codes.
Because CPT 96379 is an unlisted code, providers should submit detailed documentation explaining the service performed, why no existing CPT code applies, and the medical necessity for the procedure.
Key Facts About CPT® 96379
- Service type: Unlisted injection or infusion service
- Procedure: Therapeutic, prophylactic, or diagnostic IV or IA administration not otherwise classified
- Administration route: Intravenous (IV) or intra-arterial (IA)
- Reporting: Case-by-case with supporting documentation
- Provider type: Physicians and qualified healthcare professionals
Common clinical indications:
- Specialized infusion or injection therapies without a designated CPT code
- Emerging IV or IA administration techniques
- Unique medication administration services
- Therapeutic or diagnostic administrations not described by existing CPT codes
When to Use CPT® 96379
CPT 96379 is appropriate when:
- No existing CPT code accurately describes the IV or IA injection or infusion service performed
- The service is medically necessary and appropriately documented
- The provider can clearly explain why an unlisted code is required
- Supporting documentation is submitted for payer review
Examples:
- Administering a specialized therapeutic infusion without an established CPT administration code
- Reporting an emerging IV treatment technique not yet assigned a CPT code
- Billing for a unique intra-arterial administration procedure that cannot be reported with another administration code
- Performing a medically necessary infusion service not otherwise classified within the CPT code set
Documentation Requirements
To support CPT 96379 billing, documentation should include:
- Patient identifiers and date of service
- Clinical indication and medical necessity
- Detailed description of the injection or infusion service performed
- Medication or substance administered, when applicable
- Route of administration (IV or IA)
- Start and stop times, when applicable
- Why an existing CPT code does not accurately describe the service
- Patient response and follow-up instructions
- Provider signature and credentials
Comprehensive documentation is essential because unlisted procedure codes are frequently subject to individual payer review.
Reimbursement and Coding Considerations
- CPT 96379 is an unlisted procedure code and should only be used when no existing CPT administration code applies
- Many payers require submission of detailed supporting documentation with the claim
- A comparable CPT code may be requested to assist with reimbursement determination
- Prior authorization may be required depending on the payer and therapy provided
- Reimbursement is determined on a case-by-case basis and varies among payers
Always verify payer-specific billing requirements before submitting claims using an unlisted procedure code.
How OptiMantra Supports Infusion Documentation and Billing
OptiMantra’s integrated EMR and practice management system streamlines documentation and billing for CPT 96379:
With OptiMantra, providers can:
- Document specialized infusion and injection services using customizable templates
- Record medications administered, routes, and treatment details within the patient chart
- Track infusion history and related clinical outcomes over time
- Link administration services to diagnoses, treatment plans, and follow-up care
- Maintain organized clinical documentation that supports billing compliance and audit preparedness
- Centralize infusion documentation, scheduling, and billing workflows within one platform
By streamlining infusion management and documentation, OptiMantra helps practices improve efficiency, support compliance, and optimize reimbursement for complex administration services.
Try OptiMantra for free here!
Disclaimer: CPT® codes are maintained by the American Medical Association. This guide is for informational purposes only and does not replace official coding guidelines or payer policies.
.png)
