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Primary Care Coding Alert

Reader Questions:

Include E/M for 'Monitoring' Only If It Exceeds Injection Package

Published on Thu Apr 01, 2010

Question: An 18-year-old patient with a severe seafood allergy reports to the FP for an allergy injection. The practice's non-physician practitioner performs a pair of injections, and then observes the patient for 5 minutes after the injections to be sure he is OK. Seeing that the patient is having no adverse reactions to the injections, the NPP sends the patient home with instructions to call the practice if he feels any lingering post-injection symptoms. I know I can code for the injection, but is there an E/M code opportunity here, too? Indiana SubscriberAnswer: You'd be better off eschewing the E/M code in this instance. On the claim, report 95117 (Professional services for allergen immunotherapy not including provision of allergenic extracts; 2 or more injections) for the encounter with V07.1 (Need for isolation and other prophylactic measures; desensitization to allergens) to represent the purpose of the visit and V15.04 (Other personal history [...]
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