I am at a college health center and we will administer allergy shots to students that are established with an allergist in the area. The allergy injection serum is sent to us to administer. How would you code the allergy injection? We have submitted claims with ICD-10 code Z29.1 with the CPT for the injection which were denied.
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Wiki Immunotherapy injection coding
- Thread starter cnaivar
- Start date
mitchellde
True Blue
Are you certain that is the number? Because there are no Z29 codes in the code set. There is no direct equivalent to the V07.1 so you are to use the Z51.81 for other aftercare and the Z code for the allergy status.
Allergy injections
We realized after the fact that the Z29.1 code was removed before ICD-10 went live. If we use Z51.81 do I understand correctly that we would then need to use the Z code that specifies exactly what the allergy is to such as pollen and then the PCT code for how many injections. The patient is only being seen to have the injection. If this is correct then each patient may have a different code for what they are allergic to? Also would each allergen included in the serum need to be listed such as pollen, dust (environmental allergy), cats?
We realized after the fact that the Z29.1 code was removed before ICD-10 went live. If we use Z51.81 do I understand correctly that we would then need to use the Z code that specifies exactly what the allergy is to such as pollen and then the PCT code for how many injections. The patient is only being seen to have the injection. If this is correct then each patient may have a different code for what they are allergic to? Also would each allergen included in the serum need to be listed such as pollen, dust (environmental allergy), cats?
mitchellde
True Blue
I have always done it this way.
Shawnee
Contributor
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Allergic to Bees
T63.421D I used this icd-10 for a patient who is getting allergy shots for bees. Medicare denied as not medically necessary and sited LCD L33804 which doesn't include this diagnosis on the list for 95117. What diagnosis should I use...or are you using. I am so confused, and noticed that you also work in an allergy clinic and value your input...Thank you Debra
T63.421D I used this icd-10 for a patient who is getting allergy shots for bees. Medicare denied as not medically necessary and sited LCD L33804 which doesn't include this diagnosis on the list for 95117. What diagnosis should I use...or are you using. I am so confused, and noticed that you also work in an allergy clinic and value your input...Thank you Debra
mitchellde
True Blue
The T code is for the active allergic reaction and the follow up to the allergic reaction, and requires the allergic reaction be coded as well. You will not use the T code for prophylactic llergy injections for desensitization, you use the Z code for the other aftercare with the Z code for the allergy status.
Shawnee
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I'm still so confused!
Ok, so you are saying that I should bill Z91.038 other insect allergy status for patients getting allergy shots to desensitize?
The LCD ID L33804 doesn't have that listed as an allowed code.
A patient comes in every other week for his serum to be injected for his wasp allergy. How would you code this?
95117 with Z91.038??
Ok, so you are saying that I should bill Z91.038 other insect allergy status for patients getting allergy shots to desensitize?
The LCD ID L33804 doesn't have that listed as an allowed code.
A patient comes in every other week for his serum to be injected for his wasp allergy. How would you code this?
95117 with Z91.038??
allergy injections
I am also confused on this issue. We are an urgent care facility and have a few patients that come in for their allergy injections because we are closer to their house than the allergist. We have 1 patient that is a Medicare patient and they have always been paid for his injections with V07.1. Now, we are getting CO-50 denials as not medically necessary. I spoke to Medicare and was told to use J30.89, this was also denied. I called again and was told to use Z51.89, this was also denied. All are being denied with CO-50. Will Medicare pay for cpt 95117?
I am also confused on this issue. We are an urgent care facility and have a few patients that come in for their allergy injections because we are closer to their house than the allergist. We have 1 patient that is a Medicare patient and they have always been paid for his injections with V07.1. Now, we are getting CO-50 denials as not medically necessary. I spoke to Medicare and was told to use J30.89, this was also denied. I called again and was told to use Z51.89, this was also denied. All are being denied with CO-50. Will Medicare pay for cpt 95117?