Otolaryngology Coding Alert

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NCCI Creates Immunotherapy Prep and Diagnostic Bundles

Thanks to version 9.3 of the National Correct Coding Initiative (NCCI), you'll have to update your allergy mixology and testing skills to incorporate two edits. 1. Code Single- or Multi-Dose Vials When you bill for your physician's allergen immunotherapy preparation and supervision, you should report 95144 (Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single-dose vial[s] [specify number of vials]) or 95165 (Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single or multiple antigens [specify number of doses]). Use 95144 for mixing up a single vial for the patient or another provider to administer, and use  95165 for preparing multiple vials.
 
NCCI considers 95144 a component of 95165 but allows modifier -59 (Distinct procedural service) to override the edit. 2. Bill Only 1 Reaction-Type Test Also, make sure that you don't report 95024 (Intracutaneous [intradermal] tests with allergenic extracts, immediate type reaction, specify number of tests) with 95028 (Intracutaneous [intradermal] tests with allergenic extracts, delayed type reaction, including reading, specify number of tests). NCCI considers the allergy tests mutually exclusive. Your allergist may perform either immediate response intradermal allergy testing or delayed reaction intracutaneous allergy testing. But he may not perform both testing types at the same session.
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