Internal Medicine Coding Alert
Don't Let Venom Injections Poison Reimbursement
Question: We are having problems getting reimbursed for allergy injections for stinging insect venoms. Should we bill the same for these injections as for the other allergy immunotherapy injections? Answer: You are facing a common problem that arises among allergy immunotherapy coders, and there is an easy explanation for your predicament. The main problem regarding these codes is that you must be aware of the number of stinging insect venoms you are billing for.
Colorado Subscriber
Coding for stinging insect venom is slightly different from coding for administration of other antigens. First, you need to understand the unique codes for insect venoms. You'll use separate codes with insect antigen doses:
When you bill for venoms, the number of insects and the number of doses are important. This is different from the allergen antigens, in which the number of antigens in the vial is not relevant. CPT holds that these codes do not include the antigen administration.
If an internist prepares five doses of an antigen containing three stinging insect venoms, the coding would be 95147 x 5 and 95117 (Professional services for allergen immunotherapy ...; two or more injections) for the administration of each dose at each encounter.
Whether the doses come from the same multiple-dose vial or a series of vials does not matter because the code describes the dose, not the bottle.
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