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Wiki Allergy Vials

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hmi158

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Winston Salem, North Carolina
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I am wondering if anyone has had issues getting payment on cpt code 95165? The reimbursement, when it gets reimbursed is very small and when we called on this we were told that the RVU's were lower than that of 95028. We also don't receive any reimbursement when we bill this code with anything else. We have been referred to a CCI edit but no one knows where to find this information. I am new to allergy so not sure if there is a work around on this issue. Any advice?
 
95165

I am in Michigan. Local BCBS allowable is about $16. We try not to do medicare because of the low reimbursemt, and 1cc equals 1 unit thing. I usually do not have any other charges on mixing day, but have not had any problems with insurance not paying.
 
Yes is a problem billing with reimbursement. Agree. Lately noticing it is the doses are asking for in the log How many injections per vial etc..
 
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