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Allergy immunotherapy

Lina Posted Wed 01st of March, 2017 16:29:18 PM
Hi, I'm very confused with an allergy immunotherapy and need your help in this. So the doctor prepares the Maintenance Concentrate for total of 25ml. And starts with injecting first allergen - 0.1ml first week, then 0.2 ml second week, then 0.3ml third week, 0.4ml-week 4 and then 0.5ml 5th week. Then he continues with another allergen starting the same way 0.1 ml, 0.2ml and so on until he uses all 25ml for that specific patient. How would you code this scenario?
SuperCoder Answered Thu 02nd of March, 2017 00:19:53 AM

To report the 1st scenario, i.e., for 1st antigen, use CPT code  (Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single or multiple antigens (specify number of doses)) and CPT code 95115 (Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection) for first visit. Use CPT code 95115 for each subsequent visits. For 2nd scenario, i.e., for 2nd antigen, use the same above mentioned codes accordingly.

Lina Posted Thu 02nd of March, 2017 12:15:47 PM
For some reason it doesn't sound correct the doctor mixed 25ml right away, but was injecting starting with low dosage every week 0.1ml, 0.2 ml, 0.3ml, 0.4ml and 0.5 ml and sane thing the following week 0.1 ml 0.2 ml and so on until he used all 25 ml I would think 95165 with 25units or 50 units not sure about that bill once and then every week to bill 95115 until its all used Please let me know what you think about this Thank you
SuperCoder Answered Fri 03rd of March, 2017 00:13:29 AM

Our miss, we mentioned the code description, but missed the code. Yes, you are right, we would be billing CPT code 95165 for preparation of antigens. For units, you need to check with doctor, as how many doses were administered during the course. For 2nd antigen preparation, you need to report CPT 95165 again on respective DOS. Along with these, report CPT code 95115 for injection on each visit. Hope it clears all doubts.

Lina Posted Fri 03rd of March, 2017 11:02:10 AM
OK , so if all in all 25ml were mixed for the whole treatment for one particular patient why would I bill 95165 twice? Why can I show only once the amount of units? Can you please be specific? The preparation was done once for 25 ml total, but was injected with very small dosages by adding a dosage weekly , so that's why I asked if it could be billed 95165 50 or 25 units 95115 every week? or its incorrect? I don't think you understand my question cause your answers are not clear
SuperCoder Answered Mon 06th of March, 2017 04:56:04 AM

The whole above discussion indicates that antigens were prepared twice. 25ml first time and then again 25ml 2nd time with different antigen. If this stands true, you can be bill CPT code 95165x25 for 1st antigen preparation on respective DOS and CPT code 95165x25 for 2nd antigen preparation on respective DOS.

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