allergy

  1. K

    Wiki Allergy Extract Compounding Billing

    Need some guidance on billing for allergy compounding when outsourcing the extract compounding. My organization is looking at outsourcing our compounding but is unsure how to bill for this. Previously, we would compound ourselves and bill 95165, but I am thinking we cannot bill 95165 when...
  2. A

    Wiki Allergy Extract (95165) Made on same day patient was admitted

    Hello, I have a patient that we made allergy extract for (95165) on the same day he was admitted to the hospital for an unrelated condition. Medicare is now denying the Extract because of the admission. Does anyone know of a modifier or what we need to do to have this paid as it is unrelated...
  3. T

    Wiki Allergy Diagnosis coding

    With allergy coding, the use of T codes-especially anaphylactic response is being used liberally whenever a patient is receiving follow up care such as cluster injections or Epipen refill, and the initial/only anaphylactic response was often times years ago- would it be appropriate to change to...
  4. T

    Wiki Units for AIT and VIT Mixing

    Hello, I understand that Medicare can only be billed a maximum of 10 units per day for 95165 and 95144-95149. Is this true for all other payers as well? We typically prepare the antigens for a new AIT vial with 30 anticipated doses, a new VIT vial with 17 anticipated doses, a remixed AIT vial...
  5. K

    Wiki Allergy Office Admin Fees

    Our Allergy providers feel as if they aren't being compensated fairly for all the paperwork they are having to fill out for their patients receiving Biologics. Per our providers applications have to be completed for the pharmacy, a "Quick Start" form often has to be completed as well. They...
  6. J

    Wiki Allergy Testing Medicare Denials

    We just started seeing A TON of denials for allergy skin testing (CPT 95004) from Medicare. They said it's due to medical necessity/insufficient documentation and that we have been using non-covered ICD-10 codes since the LCD update on 7/11/2021 (L36241). I reviewed the updated LCD and can't...
  7. K

    Wiki Ingestion Challenge... via Injection?

    Hey Coders! Our allergy office gave an injection to test for an allergy to an antibiotic. They followed the same process as an ingestion challenge, but the medication was administered via an injection, not orally. I am thinking we would bill an E&M for the time we spent with the patient...
  8. L

    Wiki E&M with Allergy Testing Coding

    Our Allergists have historically charged their visits in the following way: 1st Visit- Consult or New Patient E&M 2nd Visit- Est E&M w/ mod-25 and Percutaneous Scratch Testing The day of the testing is what is now being questioned. We are being told that we cannot charge an E&M level with a...
  9. C

    Wiki 86003 and 86001 laboratory

    Hi, Has anyone experienced these codes being denied by medicare if the 86003 is over 50 we add another line with modifier 91 and if 86001 is over 20 we do the same . Medicare has been denying the 2nd lines and we have to appeal. Is there another way to keep these from denying? Thank you!
  10. J

    Wiki Preparation of sublingual allergy drops?

    Hello, I am new to allergy-related coding. We bill 95165 for the preparation of allergy vials for injection. Can 95165 also be billed for the preparation of allergy serum for sublingual drops? This clinic has been billing 95199 for the preparation of the drops and the patient self-paying...
  11. P

    Wiki Allergy/Immunotherapy- Office Visits with Allergy Injections and Modifier 25

    Good afternoon, 1. If a patient is coming in for a pre-scheduled allergy injection 95115, 95165 only is a 99212 appropriate? 2. If a patient comes in for a 99212,95117, 95165 and a modifier 25 is put on the claim is this correct? 3. Chief compliant says Allergy Injection 4. If Asthma...
  12. 0

    Wiki Outpatient Allergy shots........................

    I have had this question sent to me -- What cpt code do you think is appropriate for an outpatient allergy shot CPT 95115 for one and 95117 for two or CPT code 95120 one shot and 95125 two shot? Actually what is the difference? I’m a little confuse.
  13. AmandaRains

    Wiki Clearinghouse confusion

    I have been asked to bill allergy claims for a group that has 4 different companies with clinics in different states. They want me to bill under their information/networks and have reimbursement submitted from payor directly to them. Networking with Clearinghouses is becoming an absolute...
  14. C

    Wiki Allergy to Lidocaine testing

    I believe that I use 95018 for the drug allergy testing and list the number of tests performed. The doctor believes it is acceptable to bill 95180 with a time unit because the testing was done of a period of time with increasing dosages of Lidocaine. Finally, he ordered 2mg of Lidocaine for the...
  15. C

    Wiki milk protein intolerance ICD-10

    Please help with this ICD-10 code for milk protein intolerance - I got Z91.011- however the provider doesn't agree with this. He said "None of those truly fit as milk protein intolerance is not an allergy to milk" the more concerning is the inflammatory reaction/bleeding that happens with the...
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    • Thread
    • allergy icd-10 intolerance milk protein
    • Replies: 2
    • Forum: ICD-10
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