Injection Services

by  Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Sep 29th, 2021

Injection Service Codes

Injection service codes are reported under administration of vaccines/toxoids, using 96372, 90460, 90461, 90471, 90472, 0001A, 0002A, 0003A, 0011A, 0012A, 0021A, 0022A, 0031A, 0041A, and 0042A.

Other injections services include:

• Non-antineoplastic hormonal therapy injections – 96372
• Anti-neoplastic nonhormonal injection therapy 96401
• Anti-neoplastic hormonal injection therapy- 96402
• Allergen immunotherapy - 95115-95117

According to CMS, do not report 96372 for injections given without direct physician or other qualified health care professional supervision. To report, use 99211. Hospitals may report 96372 when the physician or other qualified health care professional is not present.

Keep in mind certain injection services such as immunizations with hepatitis B, pneumococcal, and influenza vaccines are paid under a different pricing methodology; these are not billed with a separate injection code. For example, 90748 is a combination vaccine where the injection and drug are all billed under one code.

90748 Hepatitis B and Haemophilus influenzae type b vaccine (Hib-HepB), for intramuscular use

Injection service codes are reported with 90782, 90783, 90784, 90788, and 90799. In addition, injection services are not paid for separately if the physician reports any other physician fee schedule service rendered at the same time. A/B MACs (B) must pay separately for those injection services only if no other physician fee schedule service is being paid. In either case, the drug is separately payable. If, for example, code 99211 is billed with an injection service, only code 99211 will be paid and the separately payable drug. (See section 30.6.7.D.) Injection services with immunizations with hepatitis B, pneumococcal, and influenza vaccines are not included in the fee schedule. They are paid under the drug pricing methodology as described in Chapter 17.