I have done some extensive research on this topic as we had a doctor that billing incorrectly and we wanted to help fix it. However when we told him how to bill we went by the description in the CPT books. IE bill out per antigen given in each injection. Soon the complaints started pouring in from patients as their copays and deductibles became higher. After further looking into the issue I saw that there is actually two ways of billing this code and its been debated for years. There is the antigen way of billing and then Medicares guidelines for CC's. We have tried to get ahold of several provider reps to find out how they wish the injections to be coded with no luck whatsoever. It seems that even they do not know how to bill it correctly. My biggest worry is making sure we are following the rules. As I received the information from two different crediable resources I do not believe either of them are incorrect just that there is coding differences per payor.

However, my questions is does anyone know for sure that billing per antigen is the incorrect way of billing outside of medicare and any insurance that specifically states they following medicares way of billing. Please follow up with any research or a link that states it also.

Thank you