Certified Medical Assistant (CMA AAMA)Administrative: Billing, Coding and SchedulingHard
A medical assistant is preparing to submit a claim for a patient who received allergy injections. The physician administered three different allergens. How should the medical assistant code the administration of these injections?
- AUse a single CPT code that encompasses both the administration and all allergens.
- BUse one CPT code for each allergen administered and one CPT code for each injection administration.
- CUse a single CPT code for injection administration and one code for each allergen.
- DUse a single CPT code for injection administration and a single CPT code for all allergens combined.
Show answer & explanationAnswer & explanation
Correct answer: B. Use one CPT code for each allergen administered and one CPT code for each injection administration.
For allergy injections, CPT guidelines specify coding for both the professional service of administering the injection(s) and the specific allergen extracts administered. When multiple allergens are given via separate injections, each administration and each distinct allergen should be coded separately to accurately reflect the services provided.
Why the other options are wrong
- A. This is incorrect; there is no single CPT code that combines administration and multiple distinct allergens for allergy injections.
- C. This is incorrect because each administration typically requires its own code, not just one for all.
- D. This is incorrect as it would under-represent the services; each allergen and each administration needs to be coded.
Allergy Injection Coding
Coding for allergy injections involves reporting both the administration of the injection(s) and the specific allergen extracts used.
- CPT codes 95115-95117 are for professional services of allergen immunotherapy.
- CPT codes 95144-95170 are for specific allergen extracts.
- Each distinct allergen and each administration typically requires separate coding.
Memory trick: Inject and identify! Code each shot and each bug separately.