bkosman
New
Question regarding billing of mixing vials - We are mixing 3 vials: 1 honey bee, 1 wasp, and 1 mixed vespid. We are under the impression that you should add these sting up to get 5 total. Each vial has 10 units. Would you utilize the 95149 with a total of 30 units or break them out to 3 lines with 10 units each?
If using the 95149 (10 MUE) and the 30 units would you put 10 on one line and 20 on another line to indicate over MUE? Would there be an opportunity to utilize a modifier of GZ on the units over the MUE. Also would this be a situation of getting an ABN because the patient does not present on the day of mixing fees? Is the ABN even a factor if you are over MUEs?
The follow is an excerpt from an article out of the American Academy of Allergy Asthma and Immunology.
Case Study: If the patient needs to be desensitized to white faced hornet, yellow hornet and yellow jacket, the correct code would be 95147 since there are three bees and the administration code would be 95115. All three bees are included in one extract. All of the doses that are anticipated to be given to the patient should be charged with the 95147. Again, the injection code would be coded when the bee venom is administered to the patient.
Case Study: The patient is allergy tested to all of the bees and is highly allergic to yellow faced hornet, yellow jacket, white faced hornet and honey bee. 95148 would be the appropriate code for this patient. The mixed vespids (95147) and one other bee (honey bee). Again, since the code includes all four bees, you would consider the doses in both vials as one unit for billing. The administration of the bee venom would be coded with 95117 since the mixed vespid and the additional bee are two separate injections.
If using the 95149 (10 MUE) and the 30 units would you put 10 on one line and 20 on another line to indicate over MUE? Would there be an opportunity to utilize a modifier of GZ on the units over the MUE. Also would this be a situation of getting an ABN because the patient does not present on the day of mixing fees? Is the ABN even a factor if you are over MUEs?
The follow is an excerpt from an article out of the American Academy of Allergy Asthma and Immunology.
Case Study: If the patient needs to be desensitized to white faced hornet, yellow hornet and yellow jacket, the correct code would be 95147 since there are three bees and the administration code would be 95115. All three bees are included in one extract. All of the doses that are anticipated to be given to the patient should be charged with the 95147. Again, the injection code would be coded when the bee venom is administered to the patient.
Case Study: The patient is allergy tested to all of the bees and is highly allergic to yellow faced hornet, yellow jacket, white faced hornet and honey bee. 95148 would be the appropriate code for this patient. The mixed vespids (95147) and one other bee (honey bee). Again, since the code includes all four bees, you would consider the doses in both vials as one unit for billing. The administration of the bee venom would be coded with 95117 since the mixed vespid and the additional bee are two separate injections.