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The CPT® Code 95145 refers to the professional services involved in the supervision and preparation of antigens specifically for allergen immunotherapy, focusing on a single stinging insect venom. This procedure is typically performed by an allergist or another qualified healthcare provider who is responsible for preparing multiple dose vials of antigens derived from one or more stinging insects. The preparation process is guided by the results obtained from allergy testing services, which are reported separately. These results help determine the appropriate dosage of the stinging insect allergens that will be formulated for the patient. Each multiple dose vial contains the correct formulation necessary for a specified number of injections, allowing for a structured approach to immunotherapy. The total number of doses required for the patient's treatment course is prepared in advance, and the physician reports a single code for each multiple dose vial supplied. The allergist typically administers the initial dose of the antigen, which is reported separately, and monitors the patient for any adverse reactions. Following this initial administration, the patient is provided with the multiple dose vials, and another healthcare provider is responsible for administering the subsequent doses. It is important to use the appropriate CPT codes based on the number of stinging insect venoms prepared, with code 95145 designated for a single venom, and additional codes available for multiple venoms.
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The procedure associated with CPT® Code 95145 is indicated for patients who have been diagnosed with allergies to stinging insect venoms. This includes individuals who have experienced allergic reactions to the venom of insects such as bees, wasps, or hornets. The preparation of antigens for allergen immunotherapy is typically recommended for patients who have undergone allergy testing and have shown a specific sensitivity to a single stinging insect venom. The goal of this immunotherapy is to desensitize the patient to the allergen, thereby reducing the severity of allergic reactions upon future exposure.
The procedure for CPT® Code 95145 involves several key steps that ensure the safe and effective preparation of antigens for allergen immunotherapy.
After the procedure associated with CPT® Code 95145, the patient is monitored for any adverse effects following the administration of the initial dose. It is important for the healthcare provider to observe the patient for a specified period to ensure that no immediate allergic reactions occur. Once the patient has received the initial dose and is deemed stable, they will take the multiple dose vials home for self-administration of the remaining doses. Patients are typically instructed on how to properly administer the subsequent doses and are advised to report any unusual symptoms or reactions to their healthcare provider. Follow-up appointments may be scheduled to assess the patient's response to the immunotherapy and to make any necessary adjustments to the treatment plan.
| Short Descr | ANTIGEN THERAPY SERVICES | Medium Descr | PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 1 INSECT | Long Descr | Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); single stinging insect venom | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | STV-Packaged Codes | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | M5D - Specialist - other | MUE | 10 | CCS Clinical Classification | 228 - Prophylactic vaccinations and inoculations |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | CR | Catastrophe/disaster related | 25 | Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59. | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | GA | Waiver of liability statement issued as required by payer policy, individual case | JW | Drug amount discarded/not administered to any patient | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | U1 | Medicaid level of care 1, as defined by each state | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2011-01-01 | Changed | Medium description changed. |
| 2002-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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