Otolaryngology Coding Alert

Question: My physician had to provide desensitization to a medicine a patient is allergic to. What are the details for reporting 95180?

Texas Subscriber

Answer: The patient receives "small but increasing dosages of a substance that causes a patient's allergic reaction to desensitize the patient and to develop the patient's tolerance to the substance," according to the Coders- Desk Reference's description of 95180 (Rapid desensitization procedure, each hour [e.g., insulin, penicillin, equine serum]). When a physician has established that a patient has sensitivity to a drug that is essential to treatment, you should code the desensitization procedure with 95180.

Indicate the number of hours of rapid desensitization, such as four, to a medication, for instance penicillin, in the unit's field. Because the procedure may be necessary during an emergency, 95180 is payable in the office (place-of-service code 11) and hospital settings (POS 21, 22 and 23).

Example: A patient requires penicillin treatment, but she is allergic to the medicine. The otolaryngologist desensitizes the patient to the antibiotic over three hours. You would report 95180 with a "3" in the units field, and V14.0 (Personal history of allergy to medicinal agents; penicillin).