96365
IV Infusion, Initial
Code Description
CPT code 96365 is used to report the initial intravenous infusion of a therapeutic, prophylactic, or diagnostic substance or drug. The code covers the administration service for the initial infusion lasting up to one hour and does not include chemotherapy or other highly complex biologic agent administration.
The medication or fluid administered is billed separately using the appropriate HCPCS or J-code when applicable.
When to Use 96365
Common examples include:
Intravenous antibiotic infusion
IV biologic therapy
Therapeutic medication infusion
Diagnostic medication infusion
Prophylactic medication infusion
Outpatient infusion therapy
Documentation Requirements
Documentation should include:
Reason for the infusion
Medication or substance infused
Start and stop times
Intravenous route of administration
Total infusion time
Medical necessity for the infusion
Common Billing Mistakes
Common billing mistakes include:
Reporting 96365 for IV push administration
Failing to document infusion start and stop times
Billing infusion administration without the medication
Reporting additional infusion hours incorrectly
Insufficient documentation supporting medical necessity
Related CPT Codes
96372
Therapeutic Injection
94640
Inhalation Treatment
94760
Pulse Oximetry
FAQ
What does CPT code 96365 cover?
CPT code 96365 reports the initial intravenous infusion of a therapeutic, prophylactic, or diagnostic substance lasting up to one hour.
Does CPT 96365 include the medication?
No. CPT 96365 reports only the administration of the infusion. The medication or biological agent is billed separately using the appropriate HCPCS or J-code.
What is the difference between CPT 96365 and 96372?
CPT 96365 is used for intravenous infusion administration, while CPT 96372 is used for subcutaneous or intramuscular injection administration.
Is infusion time required for CPT 96365?
Yes. Documentation should include the infusion start and stop times because the duration of the infusion is an important component of accurate code selection.
Procedure Type
Intravenous Infusion
Route
Time
Intravenous (IV)
Initial, Up to 1 Hour
