Time based CPT coding is a critical component of infusion therapy billing. Many infusion services are reimbursed according to how long the medication is administered. If time documentation is incomplete or inaccurate, claims are often downcoded or denied.

CPT codes such as 96365 cover the initial hour of infusion, while 96366 applies to each additional hour. These codes require clear start and stop times in the medical record. Without this information, payers cannot verify the service level billed.

One common issue is rounding errors. CPT guidelines specify how time should be calculated, including minimum time thresholds for billing an additional hour. Billing an extra unit without meeting the required time can result in recoupments or audits. Providers must follow CPT time rules carefully.

Another challenge involves multiple infusions during the same visit. When patients receive hydration, therapeutic infusion, and injection services together, CPT sequencing rules apply. Billing these services out of order can lead to incorrect reimbursement.

Concurrent and sequential infusions are also frequently misreported. CPT guidelines clearly define how these services should be coded, yet confusion remains common among billing teams. Incorrect reporting can cause bundling issues or denied line items.

Infusion Billing Services specializes in managing time based CPT coding for infusion therapy. Their team reviews documentation, validates infusion duration, and ensures proper sequencing and modifier usage. This helps providers receive accurate reimbursement while staying compliant with payer rules.

In summary, time based CPT coding requires precise documentation and strict adherence to guidelines. Partnering with Infusion Billing Services helps infusion providers reduce errors and optimize billing outcomes.