amsmith
Networker
We are trying to make sure that we are billing correctly in our allergy department for the services that we are providing.
Can we bill the 95165? There appears to be some confusion regarding "supervision of preparation" and the direct supervision requirements.
If not, we are open to any assistance available.
- The patient is examined in the Allergy Clinic by a licensed Allergist and subsequently allergy skin testing is performed if indicated.
- Based on the results of the skin testing, the Allergist determines that allergy immunotherapy injections are medically necessary to minimize allergy responses and the patient agrees to proceed with a series of allergy immunotherapy injections.
- The Allergist creates a prescription for allergy extract vials based on the patient’s responses to allergy testing. Each vial contains several antigens. There may be from 1 – 4 concentrated vials for the patient, depending on the range and type of allergies, along with several dilutions.
- The patient’s immunotherapy prescription is securely transmitted through a portal to a professional allergy immunotherapy compounding service.
- The patient’s antigen vials are compounded following USP 797 and all applicable guidelines. They have a board certified allergy/immunology specialist and a Pharm D on staff.
- The vials are received in the Allergy Clinic. The Allergy Clinic pays for the cost of the vials at $220 - $250/vial for a maximum of $880 - $1000 per patient if they have 4 vials.
- The antigen injections are given on a weekly basis in the Allergy Clinic by trained and licensed staff, with a supervising physician on site. We follow a structured build up, starting at 0.1 mL (cc) and increasing gradually to 0.5 cc, then to less dilute vials. We anticipate getting a minimum of 43 injections from one vial set.
Can we bill the 95165? There appears to be some confusion regarding "supervision of preparation" and the direct supervision requirements.
If not, we are open to any assistance available.