Pulmonology Coding Alert

Question: Please tell me how to bill for 95144 at three vials, and 95180 at eight injections. Also, how much should our practice charge?

Illinois Subscriber

Answer: You should bill 95144 (Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single-dose vial[s] [specify number of vials]) at three units (95144 x 3).

You should report this code when your physician prepares the antigen that another physician administers.
You should not report this code if your physician prepares and also provides the injections to the patient.

You should report 95180 (Rapid desensitization procedure, each hour [e.g., insulin, penicillin, equine serum]) for rapid desensitization for each hour. You should multiply the code by the number of hours the patient requires for desensitization. For example, if the process takes three hours, you should bill 95180 x 3.

Bottom line: According to the Medicare fee schedule, Medicare reimburses $8.21 for 95144 and $133.67 for each hour of desensitization for 95180, so you want to make sure you get it right the first time.