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Thread: venom antigen coding

  1. #1
    Join Date
    Apr 2007
    sioux falls sd

    Question venom antigen coding

    AAPC: Back to School
    I was wondering if there was anyone out there who codes for an allergist that gives venom antigen shots. We are having a hard time figuring out what code to use for this. We have pts. that come in and get 3 different injections at one time - 2 are single venoms and one is 3 venoms in one shot. We dont know if we should use the 99145 x2 with 99147 x1 or 99149 ? There is also the question of should we be using the codes for mixing and giving the shot on the same day which we do with these patients becuse their insurance requires that they only get charged for a dose at a time. Normally we dont use those codes because we premix for them.
    If anyone has been down this road before i would love to hear from you.
    lisa Y
    Last edited by youngl; 10-28-2008 at 01:31 PM.

  2. #2
    Join Date
    Apr 2007

    Default Venom Injection Coding

    Hello Lisa,
    I work for an Allergist in Mass. I am not familiar with the codes you are using to bill for venom injections(99415-99417). When we bill for venom injections we use codes 95115 & 95117 for the injection itself. Then we use codes 95146-95149 (specify units or doses) to bill for the venom extract. We mix our own extracts.
    Therefore a person getting injections for wasp,yellow jacket, and hornet will be billed 95117 , 95145 (3 units).

    If you bill for an extract that is a mix you would use codes 95146 - 95149. For example mixed vespid has 3 different venoms in the mix so you would use code 95147 (3 single stinging insect venoms).
    Also bill code 95115 for the injection.

    I hope this helped. If you need any further help or questions you can e-mail me directly @ cbarb8891@comcast.net.

    Christine Barboza, CPC
    Allergy & Asthma CAre, PC
    2007 Bay Street, Se 101
    Taunton, MA. 02780

  3. #3
    Join Date
    Apr 2007
    sioux falls sd


    sorry i am a little dyslexic we do use the 95145-95149
    my question is: if i give injections from 3 different bottles- 2 bottles containing 1 venom each and then one injection of the mixed vespids with 3 venoms - do i charge a 99149( for the 5 venoms) or 99145 X2 and 99147X1?
    we have had insurance carriers pay both ways. but only one way can be right. i have read a lot about it and looked at many examples but there is never any with this situation so i just cant tell for sure which way to do it.

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