Wiki Allergy/Immunotherapy- Office Visits with Allergy Injections and Modifier 25

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pashirley

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Good afternoon,


1. If a patient is coming in for a pre-scheduled allergy injection 95115, 95165 only is a 99212 appropriate?

2. If a patient comes in for a 99212,95117, 95165 and a modifier 25 is put on the claim is this correct?

3. Chief compliant says Allergy Injection

4. If Asthma is not being addressed within that visit is it appropriate to put this as a ICD-10 code in the diagnosis?

Any help would be greatly appreciated
 
pashirley said:
Good afternoon,


1. If a patient is coming in for a pre-scheduled allergy injection 95115, 95165 only is a 99212 appropriate?

2. If a patient comes in for a 99212,95117, 95165 and a modifier 25 is put on the claim is this correct?

3. Chief compliant says Allergy Injection

4. If Asthma is not being addressed within that visit is it appropriate to put this as a ICD-10 code in the diagnosis?

Any help would be greatly appreciated
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#1. No 99212 is not appropriate
#2. If the purpose of the encounter is to receive the injection, the 99212 should not be billed.
#3. If the reason for the visit is to receive the injection then that is all that is billed out no E&M
#4. If asthma is not an issue at thus encounter and is not treated then it should not be coded.
You should use a Z code for an encounter to receive allergy injections.
 
Allergy Injections

Thank you i appreciate the feedback. I wanted to ask another question in regards to this. If the allergies determines that there patient conditions changes and then becomes worse and has to modify or adjust the dosage and they meet the requirements for the E/M this would constitute a E/M as he is actually monitoring or evaluating the progress of the dosage.

Also the documentation within the Medicate website can be very vague. Does anyone have a good link or document for the allergy information. If you do i would so appreciate if you could reply back and send it to me.:)
 
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