CPT codes define how infusion therapy services are billed and reimbursed. Unlike diagnosis coding, CPT coding focuses on the procedure itself, including the type of infusion, duration, and sequence. Accurate CPT coding is critical for infusion providers who want to avoid underbilling, overbilling, or payer audits.

Infusion CPT codes are time based and service specific. Codes such as 96365 represent the initial hour of intravenous infusion, while 96366 is used for each additional hour. Hydration, chemotherapy, and therapeutic infusions all have different CPT requirements. Selecting the wrong code can significantly impact reimbursement.

Start and stop times are a common problem in CPT infusion billing. Many payers require exact infusion times to support time based codes. If documentation does not clearly show when the infusion began and ended, payers may downcode the service or deny it entirely. This makes nursing and clinical documentation essential for billing success.

Modifiers also play an important role. Modifier -59 may be required when multiple infusion services are performed during the same visit. Failing to apply modifiers correctly can result in bundled payments or denied line items. Each payer has specific rules, making CPT coding even more complex.

Another issue is billing concurrent or sequential infusions. CPT guidelines clearly define how these services should be reported, yet errors remain common. Billing infusion services out of sequence or misclassifying them can trigger audits.

Infusion Billing Services specializes in CPT coding for infusion therapy. Their team reviews clinical documentation, validates infusion times, applies correct modifiers, and ensures compliance with payer specific CPT rules. This reduces denials and ensures providers are reimbursed for the full scope of services delivered.

In summary, accurate CPT coding for infusion therapy requires attention to detail, proper documentation, and deep knowledge of payer rules. With support from Infusion Billing Services, infusion providers can reduce coding errors and protect revenue.