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CPT 95165

T

tkmoore312@gmail.com

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5
Location
Thomasville, GA
I work for an ENT and we treat allergy patients. When the patient gets new antigen serum mixed for allergy shots we bill 95165. Recently Aetna and UMR/UHC have been requesting medical records for these claims. Problem is they do not see the Doctor so there are no office notes. The nurse notates their account that new serum was mixed and notates the ledger book. I have tried sending their allergy test results to show why they are getting the shots but they are denying the claims stating the medical records don't support the charge. Most of these patients self administer the allergy shots at home. I'm at a loss for how to handle these claims. When I've submitted the records I've included a letter explaining that this charge is for allergy antigen serum and as such there is no office note.

Any suggestion/advice?
 
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