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2734Re: CPT 95117

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  • Melinda
    Nov 1, 2007
    • 0 Attachment
      Multiple allergy shots

      Q If I give two allergy shots to a patient on the same day, should I
      code 95115 and 95117, or just 95117?

      A You should code 95117 for two or more injections. Code 95115 should be
      used only when a single injection is given on a date of service. Code
      95117 should be reported just once per patient per date of service.

      http://www.aafp.org/fpm/20060900/coding.html
      <http://www.aafp.org/fpm/20060900/coding.html>

      Melinda Brown, CMBS
      Ins Biller

      --- In MedicalBillers@yahoogroups.com, Joktan Edison <ejoktan@...>
      wrote:
      >
      > Barbara,
      >
      > We are currently billing CPT 95117 with 2 units,
      > however UHC pays only 1 unit and not for other units.
      >
      > Can't we use any modifier like colonoscopy code (what
      > was discussed today). Apart from that all other
      > insurance pays for both the units and it is only UHC
      > does not.
      >
      >
      > --- B Burgess granbfly@... wrote:
      >
      > > Then you would bill 95117 once only. The code
      > > description is for "two or more" injections. 95115
      > > would be for a single injection. It's kinda like
      > > the colonoscopy code questions on the group today.
      > > You don't bill in individual units becase the code
      > > description IS for more than one.
      > >
      > > Barbara Burgess, RN, CPC, ACS-EM
      > >
      > > Joktan Edison ejoktan@... wrote:
      > > Barbara, we are giving two shots.
      > >
      > > --- B Burgess granbfly@... wrote:
      > >
      > > > How many allergy shots are you giving ?
      > > >
      > > >
      > > >
      > > > ejoktan ejoktan@... wrote:
      > > > We bill 2 units for the above mentioned
      > > > CPT, however UHC only pays for
      > > > 1 unit and for the other one they request
      > > additional
      > > > documentation in
      > > > order proof this is medical necessity.
      > > >
      > > > Any feedback how to get this paid one shot without
      > > > any paper work would
      > > > be appreciated.
      > > >
      > > > Looking forward for any kind of suggestion to
      > > handle
      > > > this with UHC.
      > > >
      > > >
      > > >
      > > >
      > > >
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