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Use CPT® procedure code 95180 (rapid desensitization) when sensitivity to a drug has been established and treatment with the drug is essential. This procedure will also require frequent monitoring and skin testing. The number of hours involved in desensitization must be reported in the unit field. A visit to an allergist, which yields a diagnosis of specific allergy sensitivity but does not include immunotherapy, should be coded according to the level of care rendered.
CPT® code 95180 (Rapid desensitization procedure, each hour [e.g., insulin, penicillin, equine serum]) is reportable for rapid desensitization for each hour. You can bill this code as multiply the code by the number of hours the patient requires for desensitization. For example, if the process takes three hours, you should bill 95180 x 3. CPT® code 95180 is an hourly billing code (One hour=one unit)
Venom immunotherapy often begins with 3 injections of dilute antigen given each week for a number of weeks but is not cluster or rapid desensitization. It is billed as one unit of the venom code, depending on the number of stinging insects plus CPT® code 95117 (for the administration of two or more injections).
95144-95170 is used for the provision of the antigen mixing of the vials that are specific to each patient.
Code 95144 is for single-dose vials, where the physician empties a vial, injects the patient, and disposes of the bottle. This code is billed according to the number of vials prepared for the patient. 95144 (Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single-dose vial[s] [specify number of vials]). For example: at three units (95144 x 3).
At the subsequent visit, the physician uses the next bottle marked in sequence. Both 95144 and the subsequent codes, should be used in conjunction with 95115 and 95117.
Codes 95145-95170 are billed according to the number of doses, not the number of antigens in the doses. In other words, if the vial contains 20 different antigens and eight doses, the physician bills for eight doses.
The physician who created the antigen material puts the number of doses in the units column of the claim form when it is submitted.
Note: Allergy testing is not performed on the same day as allergy immunotherapy in standard medical practice. These codes should, therefore, not be reported together. Additionally, the testing becomes an integral part to rapid desensitization kits (CPT® code 95180) and would therefore not be reported separately.
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