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Thread Topic: Allergy billing question
Topic Originator: Michelle Rimmer
Post Date October 7, 2008 @ 12:02 AM
Allergy billing question


Michelle Rimmer
October 7, 2008 @ 12:02 AM Reply  |  Email Friend   |  |Print  |  Top

This is one for the allergy billers!!

A former student of mine tells me she only bills for an OV when the patient is first seen as a new patient and when the vial runs out.....any other time the pt comes in for an allergy shot--she only bills 95117 and NO OFFICE VISIT.........

Is this the way any of you allergy billers bill as well?

Do any of you bill out a 99211 along with the 95117 when the pt comes in weekly for the shot?

If so, why?  If not, why?

Thanks!!

steve verno
October 7, 2008 @ 7:24 AM Reply  |  Email Friend   |  |Print  |  Top

THis is a coders personal preference that no one is going to say o do to change ther mind on what could be coded properly.  

I once had a student who refused to bill a level 5 office visit even though everything was documented at a level 5 visit.  she faild the test question and would appeal her grade with no basis behin dher appeal other than she doesnt believe in a level 5 visit.  

Another stident refused to use modifiers with her claims.  She constantly e-mailed me on how to appeal this. I said use modifier (x), she would ask for an alternate mething of appealing that did not involve a modifier.

The people being hurt by these coders personal preferrences and beliefs are the doctors, not you or me.  We an only guide the person to do what Guidelines says is correct.

Love my job
October 29, 2008 @ 1:25 PM Reply  |  Email Friend   |  |Print  |  Top

Michelle,
When a patient is on weekly allergy injections the insurance companys will not pay for an office visit. I worked for an allergist for 7 yrs and unless he see's the patients for being sick or new vials they never paid for visits.  Most allergist have the nurses giving out the allergy shots and they only pay for the injection and serum and most insurances dont charge copays either.  So your student was correct because it seems that all allergist work the same way.  I have spoken with other allergists and they do the same billing.. Hope this helps!

Michelle Rimmer
October 29, 2008 @ 1:37 PM Reply  |  Email Friend   |  |Print  |  Top

Thank you 'Love my job'.

Pam
November 1, 2008 @ 3:45 PM Reply  |  Email Friend   |  |Print  |  Top

We only bill the 95115 or 95117, as it is only for the shots -- the patient is not seeing the doctor.  The insurance companies won't pay for an office visit in addition to the shot, when the shot is all they are getting.

ZORAYAH
March 31, 2017 @ 3:43 PM Reply  |  Email Friend   |  |Print  |  Top

I BILL FOR A SHOT USING 95117/95165 MAKING OF SHOT AND ADMINISTERING IT



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