96375

Therapeutic, Prophylactic, or Diagnostic Injection; Each Additional Sequential IV Push of a New Substance

CPT code 96375 is a specialized add-on code used to report the administration of a therapeutic, prophylactic, or diagnostic substance through an intravenous (IV) push. For coding purposes, an IV push is defined as an injection that takes 15 minutes or less to complete or is administered as a bolus directly into a venous access device. This specific code is utilized when a healthcare provider administers a subsequent, different drug or substance following an initial primary service. As an add-on code, 96375 cannot be billed alone; it must be reported in conjunction with a primary administration code such as 96374 (initial IV push), 96365 (initial IV infusion), or 96409 (initial chemotherapy IV push). The 'sequential' nature of this code implies that the substances are administered one after another through the same access point. It is critical to note that 96375 is strictly for the administration of a different drug. If the same drug is administered as a second push in a facility setting, a different code (96376) would be applicable. The procedure involves the professional oversight of the injection, monitoring the patient for immediate adverse reactions or hypersensitivity, and ensuring proper drug compatibility between the sequential agents. This code reflects the additional clinical work and risk assessment required when managing polypharmacy in an acute or outpatient setting, such as the emergency department, observation unit, or a physician's office.

Clinical Indications

  • Management of acute pain requiring sequential administration of different analgesics or adjuncts
  • Treatment of severe nausea and vomiting requiring multiple antiemetic agents
  • Emergency treatment of allergic reactions or anaphylaxis requiring sequential epinephrine and corticosteroids
  • Administration of sequential antibiotics for suspected multi-organism sepsis
  • Procedural sedation where multiple different sedative or analgesic agents are administered sequentially
  • Management of hypertensive crises requiring sequential doses of different antihypertensive agents
  • Acute cardiac care requiring sequential administration of antiarrhythmics and electrolytes

Procedure Steps

  1. Verification of the secondary medication order and patient identity.
  2. Assessment of the existing intravenous access site for patency and signs of infiltration or phlebitis.
  3. Preparation of the second therapeutic, prophylactic, or diagnostic substance using aseptic technique.
  4. Flushing of the IV line with saline or a compatible solution to ensure the primary drug has cleared the tubing (if applicable).
  5. Slow manual administration of the new drug (IV push) over a period of 15 minutes or less.
  6. Post-administration flush of the IV line to ensure the full dose of the secondary medication is delivered to the systemic circulation.
  7. Continuous monitoring of the patient for immediate side effects, drug-drug interactions, or allergic responses.
  8. Documentation of the specific drug name, dosage, time of administration, and patient response in the medical record.

Coding Guidelines

  • 96375 is an add-on code and must be reported with a primary procedure code (e.g., 96365, 96374, 96409, 96413).
  • Use 96375 for each additional new substance or drug administered as a sequential IV push.
  • Do not report 96375 for the administration of the same drug multiple times; for facility reporting of the same drug, use 96376.
  • Do not report 96375 for IV flushes used to maintain line patency; flushes are considered bundled into the administration service.
  • In the office setting, 96375 requires direct physician supervision; in the hospital setting, it follows facility-specific supervision rules.
  • Do not report 96375 for substances administered during a surgical or anesthesia procedure unless the service is unrelated to the surgery.
  • This code should not be used for the administration of chemotherapy or highly complex biologicals (refer to 96411 for sequential chemotherapy pushes).

Associated ICD-10 Codes