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The CPT® Code 95170 refers to professional services involved in the supervision of the preparation and provision of antigens specifically for allergen immunotherapy. This procedure is particularly focused on whole body extracts derived from biting insects or other arthropods. In this context, an allergist or qualified supplier is responsible for preparing or overseeing the preparation of multiple dose vials containing the necessary antigens. These antigens are formulated based on the results obtained from allergy testing services, which are reported separately. The formulation process ensures that the correct dosage of the allergen is provided to the patient, allowing for effective immunotherapy. Each multiple dose vial is designed to contain the appropriate formulation for a specified number of injections, facilitating a structured approach to allergen exposure. For a complete course of immunotherapy, the allergist prepares the required multiple dose vials and utilizes CPT® Code 95170 to report the provision of a whole-body extract of a biting insect or other arthropod, while also specifying the number of doses contained within each vial. Typically, the allergist 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 responsible for taking the multiple dose vials to another healthcare provider who will administer the subsequent doses as part of the ongoing treatment plan.
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The procedure associated with CPT® Code 95170 is indicated for patients who require allergen immunotherapy specifically targeting allergens from biting insects or other arthropods. This may include individuals who have experienced allergic reactions to insect bites or stings, such as those from bees, wasps, or other similar arthropods. The preparation of antigens is based on the results of allergy testing, which identifies the specific allergens to which the patient is sensitive. The goal of this immunotherapy is to desensitize the patient to these allergens, thereby reducing the severity of allergic reactions over time.
The procedure for CPT® Code 95170 involves several key steps that ensure the effective preparation and provision of antigens for allergen immunotherapy.
Post-procedure care following the administration of the initial dose of allergen immunotherapy is essential for patient safety and monitoring. The allergist observes the patient for any immediate adverse effects, which may include allergic reactions or anaphylaxis. Patients are typically advised on how to recognize signs of an allergic reaction and the importance of seeking immediate medical attention if such symptoms occur. After the initial dose, the patient will continue with the prescribed immunotherapy regimen, which involves administering the remaining doses as directed. It is important for patients to adhere to the schedule for subsequent doses to achieve optimal desensitization and therapeutic outcomes. Regular follow-up appointments may be scheduled to assess the patient's response to the therapy and make any necessary adjustments to the treatment plan.
| Short Descr | ANTIGEN THERAPY SERVICES | Medium Descr | PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY WHL INSE | Long Descr | Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; whole body extract of biting insect or other arthropod (specify number of doses) | 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 | 237 - Ancillary Services |
| XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | GA | Waiver of liability statement issued as required by payer policy, individual case | 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. | 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. | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GZ | Item or service expected to be denied as not reasonable and necessary |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2011-01-01 | Changed | Medium description changed. |
| 2002-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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