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Allergy Injections - If a patient receives three allergy

  1. Arrow Allergy Injections - If a patient receives three allergy
    Medical Coding Books
    If a patient receives three allergy shots in the same visit, is it correct to bill
    95117 (professional services for allergen immunotherapy not including provision of allergen extracts, 2 or more injections) and 95165 (professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, single or multiple; and should we indicate 3 units with each code. Your help is greatly appreciated, ASAP. Many thanks

  2. #2
    Greeley, Colorado
    If the patient brings their own antigens and you are only administering the shots, 95117 is all you can bill (x1 since it is for 2 or more injections).
    Lisa Bledsoe, CPC, CPMA

  3. #3
    Question Allergy shots
    We are having a little trouble billing these out also! What code would you use if the patient does not bring in their own meds?
    Teresa A. Carrasco, CPC:

  4. Default
    If you are mixing and providing the antigen, then you bill the 95165 with the appropriate # of units. Remember that medicare guidelines state one dose equals 1cc so even if you use an escalating scale giving a range of doses, you still bill based on a 1cc dose.

    If you have a 10cc vial, then you bill out 95165 x 10

    You then bill the appropriate injection code 95115 for 1 injection or 95117 for 2 or more.

    Next question is do you mix a multi use vial or single use vial?

    our practice mixes ever 12 wks 2 vials for each patient. At that time the 95165 is billed out with appropriate units for # of cc's. (two vials because animals, mites and molds in one- tree's grasses and weeds in other)

    Each visit they are billed out 95117 as they get two injections (one from each vial)
    Rachell Lindley, CPC
    Multispecialty Clinic Coding
    Internal Medicine
    General Surgery
    Family Medicine

  5. #5
    Thank you for your reply! This has been a big help! =0)
    Teresa A. Carrasco, CPC:

  6. Default
    Scenerio: New vial is mixed, patient comes in for 1st injection from that vial. Patient is given a small amount of the injection, watched for reaction and then the complete injection is given if there is no reaction. Can the office bill for the "test" injection AND 95115 for the remainder? It has been suggested that we should bill 95120 for those visits, but that doesn't seem right to me.

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