Wednesday, May 8, 2013

Allergy Immunotherapy Billing

Whoever wrote “April showers bring May flowers” held the key to the peak Allergy and Asthma season.  May has been designated an awareness month for Allergy and Asthma by the Asthma and Allergy Foundation on America (AAFA).  Asthma and allergy are commonly “linked” together as allergies can be one of the major contributing factors for those patients diagnosed with asthma.

Asthma and allergy have been estimated to affect one in five Americans.  As a health care professional, there are significantly high odds you encounter these conditions in a high proportion of your patient population.  If you are a primary care type provider, you may be able to adequately treat those mild sufferers.  For those with more severe symptoms, a referral to an Allergy and Asthma Specialist will be warranted.

A common treatment for allergies is Allergen Immunotherapy or “allergy shots”.  This type of treatment is prescribed by the Allergy specialist who also may administer the treatment personally.  In today’s healthcare environment though, many managed care organizations prefer the patient receive the treatment via their assigned primary care provider.  The table below provides CPT codes that are used in the billing of allergen immunotherapy.

CPT CODE
DESCRIPTION
95115
One Injection only, no serum-PROFESSIONAL SERVICES FOR ALLERGEN IMMUNOTHERAPY NOT INCLUDING PROVISION OF ALLERGENIC EXTRACTS; SINGLE INJECTION
95117
Two or more injections,  no serum-PROFESSIONAL SERVICES FOR ALLERGEN IMMUNOTHERAPY NOT INCLUDING PROVISION OF ALLERGENIC EXTRACTS; 2 OR MORE INJECTIONS
95144
Serum only, single dose vial, bill number of vials-PROFESSIONAL SERVICES FOR THE SUPERVISION OF PREPARATION AND PROVISION OF ANTIGENS FOR ALLERGEN IMMUNOTHERAPY, SINGLE DOSE VIAL(S) (SPECIFY NUMBER OF VIALS)
95145
Single insect venom only, multi-dose vial, bill number of does-PROFESSIONAL SERVICES FOR THE SUPERVISION OF PREPARATION AND PROVISION OF ANTIGENS FOR ALLERGEN IMMUNOTHERAPY (SPECIFY NUMBER OF DOSES); SINGLE STINGING INSECT VENOM
95146
Two insect venoms only, multi-dose vial, bill number of does-PROFESSIONAL SERVICES FOR THE SUPERVISION OF PREPARATION AND PROVISION OF ANTIGENS FOR ALLERGEN IMMUNOTHERAPY (SPECIFY NUMBER OF DOSES); 2 SINGLE STINGING INSECT VENOMS
95147
Three insect venoms only, multi-dose vial, bill number of does-PROFESSIONAL SERVICES FOR THE SUPERVISION OF PREPARATION AND PROVISION OF ANTIGENS FOR ALLERGEN IMMUNOTHERAPY (SPECIFY NUMBER OF DOSES); 3 SINGLE STINGING INSECT VENOMS
95148
Four insect venoms only, multi-dose vial, bill number of does-PROFESSIONAL SERVICES FOR THE SUPERVISION OF PREPARATION AND PROVISION OF ANTIGENS FOR ALLERGEN IMMUNOTHERAPY (SPECIFY NUMBER OF DOSES); 4 SINGLE STINGING INSECT VENOMS
95149
Five insect venoms only, multi-dose vial, bill number of does-PROFESSIONAL SERVICES FOR THE SUPERVISION OF PREPARATION AND PROVISION OF ANTIGENS FOR ALLERGEN IMMUNOTHERAPY (SPECIFY NUMBER OF DOSES); 5 SINGLE STINGING INSECT VENOMS
95165
Serum only, multi-dose vial, bill number of doses-PROFESSIONAL SERVICES FOR THE SUPERVISION OF PREPARATION AND PROVISION OF ANTIGENS FOR ALLERGEN IMMUNOTHERAPY; SINGLE OR MULTIPLE ANTIGENS (SPECIFY NUMBER OF DOSES)

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