Pulmonology Coding Alert

Question: How can we get paid for two or more allergy injections (each different medications) with codes 95125 and 95117 with the requirement to bill each injection as one unit? The code definitions say two or more injections.

Kentucky Subscriber

Answer: Both 95125 (Professional services for allergen immunotherapy in prescribing physician's office or institution, including provision of allergenic extract; two or more injections) and 95117 (Professional services for allergen immunotherapy not including provision of allergenic extracts; two or more injections) include "two or more" injections of allergen extracts. Because the code definitions describe more than one injection, the payment received is provided for multiple injections. There is no way to list each of the injections as a separate unit.

Answers to You Be the Coder and Reader Questions were provided by Carol Pohlig, BSN, RN, CPC, reimbursement analyst for the department of medicine at the University of Pennsylvania in Philadelphia; Mary Mulholland, RN, BSN, CPC, a reimbursement analyst for the office of clinical documentation at the University of Pennsylvania's department of medicine in Philadelphia; and Charlie Strange, MD, FCCP, director of the medical intensive care unit at the Medical University of South Carolina in Charleston.