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Why Proper Coding for IV Ketamine Matters – and What You Should Do
Medical Mutual of Ohio·Psychiatry, Pain Management·Coding
We identified it
Jun 20, 2026
Summary
Medical Mutual updated guidance on proper coding for IV ketamine treatments to prevent claim denials. The policy emphasizes billing ketamine as a behavioral health treatment using appropriate psychiatric diagnosis codes (F33.2 for treatment-resistant depression) and proper procedure codes (96372 for administration) rather than billing as administrative visits or anesthesia services.
Action Required
Immediately: Review all IV ketamine billing procedures to ensure use of appropriate behavioral health diagnosis codes (F33.2 for treatment-resistant depression) and procedure code 96372 for administration. Stop billing ketamine treatments as administrative office visits or anesthesia services when the indication is psychiatric. Update documentation requirements to include prior treatment failures, current symptoms, and clinical rationale for ketamine therapy.