Wiki Allergy and Immunology services rendered in POS 19 or 22

[Bonnie M]

If Allergy and Immunology services are rendered in POS 19 or 22, is CPT 95115 or 95117 billable when performed by clinical staff, or is this service included in the facility fee? What about if a provider personally performs the services in the same setting?

 

[catherinetinkey@entmedicalservices.org]

Medicare guidelines: CPT procedure codes 95115 and 95117 are payable only in an office setting.

CPT procedure codes 95144 and 95145-95170 are payable in the office and outpatient hospital (off-campus/on-campus) settings. These codes are also payable in a skilled nursing facility, but only if the physician is present.

CPT procedure code 95180 is payable in office, outpatient hospital (off-campus / on-campus), inpatient hospital, and emergency room settings.