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Carlos Posted Wed 27th of July, 2016 08:14:34 AM
What is the proper way to bill for CPT code 95165 preparation and supervision of immunotherapy and the injection code for this 95117 to Medicaree? There are 3 categories of this immunotherapy and must of Dr. Santos's patient has more than one. I understood that we need to add the units to CPT 95165 and based on the categories each set has 42 units. WE billed this code with the complete amount of units for one date of service and we got denied. Also since we are giving more that one injection when the patient comes for the injection we are billing CPT 95117 with 2 or 3 units depending on the amount of injection and we got also denied. Then we need to know how to use the above mention codes and the units. Thank you
SuperCoder Answered Thu 28th of July, 2016 08:17:43 AM
Hi, CPT procedure code 95165 is used to report multiple dose vials of non-venom antigens. When billing code 95165, providers should report the number of units representing the number of 1 cc doses being prepared. A maximum of 10 doses per vial is allowed for Medicare billing, even if more than ten preparations are obtained from the vial. In cases where a multi-dose vial is diluted, Medicare should not be billed for diluted preparations in excess of the 10 doses per vial allowed under code 95165. Always use the component codes (95115, 95117, 95144-95170) when reporting allergy immunotherapy services to Medicare. Report the injection only codes (95115 and 95117) and/or the codes representing antigens and their preparation (95144-95170). For more information follow undermentioned link

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