CPT® 96367

Does BCBS cover the CPT® 96367 or is there any particular modifier should to be added, pls reply if anyone know on this?

re: CPT® 96367

This is an "add on" code for sequential infusion(s), meaning you are giving some other infusion as the primary ("initial") infusion, i.e., chemo. A 59 modifier may be necessary. We have a problem with Colorado BCBS splitting our chemo claims and denying the add on codes for additional therapeutic/palliative infusions because the "initial" admin code is on a separate claim. If that is your problem, you should send an adjustment request referring to the (other) claim with the appropriate "initial" infusion admin code. If you are infusing only one therapeutic substance, then you need to use 96365 for the first hour, and 96366 for each additional hour beyond 31 minutes.