You Be the Coder:
Take the Sting Out of Insect Venom Injections
Published on Wed Jan 01, 2003
Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: We are having problems getting reimbursed for allergy injections for stinging insect venoms. Should we bill the same for these injections as for the other allergy immunotherapy injections?
Colorado Subscriber
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Answer: You are facing a common problem that arises among allergy immunotherapy coders, and there is an easy explanation for your predicament. Coding for stinging insect venom is slightly different from coding for administration of other antigens. First, you need to understand the unique codes for insect venoms. Separate codes are used in conjunction with insect antigen doses:
95145 Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); single stinging insect venom
95146 ... two single stinging insect venoms
95147 ... three single stinging insect venoms
95148 ... four single stinging insect venoms
95149 ... five single stinging insect venoms
95170 Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; whole body extract of biting insect or other arthropod (specify number of doses).
The main problem regarding these codes is that you must be aware of the number of stinging insect venoms for which you are billing. Jernigan adds that, when you bill for venoms, the number of insects and the number of doses is important. This is different from the allergen antigens in which it is not relevant how many antigens are in the vial. CPT holds that these codes do not include the administration of the antigen.
If a pulmonologist prepares two doses of an antigen containing three stinging insect venoms, then the code would be 95147 x 2 and 95117 (Professional services for allergen immunotherapy ...) for the administration. It does not matter whether the doses come from the same multiple-dose vial or a series of vials, because the code describes the dose, not the bottle. | |
