How To Use CPT Code 95134

CPT 95134 describes the professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified healthcare professional, including the provision of allergenic extract for five stinging insect venoms. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 95134?

CPT 95134 can be used to describe the professional services provided by a healthcare professional for allergen immunotherapy in the office or institution of the prescribing physician. This code specifically includes the provision of allergenic extract for five stinging insect venoms. It is used when the healthcare professional administers the allergenic extract to a patient to treat or prevent an allergic reaction to the sting of these insects.

2. Official Description

The official description of CPT code 95134 is: ‘Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified healthcare professional, including provision of allergenic extract; 5 stinging insect venoms.’

3. Procedure

1. The healthcare professional prepares the patient for the allergen immunotherapy procedure.
2. The healthcare professional administers the allergenic extract for five stinging insect venoms to the patient.
3. The patient may receive a series of injections over time, with the quantities of the allergenic extract gradually increasing to achieve clinical tolerance of the allergens.
4. The healthcare professional monitors the patient for any adverse reactions during and after the procedure.
5. Additional sessions may be scheduled as needed to complete the allergen immunotherapy treatment.

4. Qualifying circumstances

Patients eligible to receive CPT 95134 services are those who are allergic to the sting of five specific stinging insects and require allergen immunotherapy treatment. The healthcare professional must administer the allergenic extract in the office or institution of the prescribing physician or other qualified healthcare professional. The patient’s allergy must be confirmed through appropriate diagnostic testing, and the treatment must be deemed necessary by the healthcare professional.

5. When to use CPT code 95134

CPT code 95134 should be used when a healthcare professional provides professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified healthcare professional. This code specifically includes the provision of allergenic extract for five stinging insect venoms. It should be reported for each session of allergen immunotherapy involving these specific venoms.

6. Documentation requirements

To support a claim for CPT 95134, the healthcare professional must document the following information:

• Patient’s diagnosis of allergy to the specific stinging insect venoms
• Details of the allergenic extract administered, including the specific venoms and the quantities used
• Date and time of the procedure
• Monitoring of the patient during and after the procedure
• Progress made by the patient and any additional sessions scheduled
• Signature of the healthcare professional providing the service

7. Billing guidelines

When billing for CPT 95134, ensure that the healthcare professional providing the service is a prescribing physician or other qualified healthcare professional. The service must be performed in the office or institution of the prescribing physician or other qualified healthcare professional. It is important to note that if the preparation of the allergen extract is performed by someone other than the provider who administers the injection, separate codes should be used for the preparation and administration. It is also important to follow any specific guidelines or policies set by the payer regarding the reporting of allergen immunotherapy services.

8. Historical information

CPT 95134 was added to the Current Procedural Terminology system on January 1, 1990. There have been two code changes since its addition, with the most recent change occurring on January 1, 2013.

9. Examples

1. A physician administering allergen immunotherapy for a patient allergic to the stings of five specific insects.
2. A nurse providing professional services for allergen immunotherapy in the office of a prescribing physician, including the provision of allergenic extract for five stinging insect venoms.
3. A qualified healthcare professional administering allergen immunotherapy to a patient with confirmed allergies to the stings of five specific insects.
4. A physician performing allergen immunotherapy in the institution where they practice, including the provision of allergenic extract for five stinging insect venoms.
5. A healthcare professional administering allergen immunotherapy to a patient with a diagnosed allergy to the stings of five specific insects in the office of a qualified healthcare professional.
6. A prescribing physician providing professional services for allergen immunotherapy, including the provision of allergenic extract for five stinging insect venoms.
7. A qualified healthcare professional administering allergen immunotherapy to a patient with confirmed allergies to the stings of five specific insects in the institution where they practice.
8. A nurse providing professional services for allergen immunotherapy in the office of a prescribing physician, including the provision of allergenic extract for five stinging insect venoms.
9. A healthcare professional administering allergen immunotherapy to a patient with a diagnosed allergy to the stings of five specific insects in the office of a qualified healthcare professional.
10. A physician performing allergen immunotherapy in the institution where they practice, including the provision of allergenic extract for five stinging insect venoms.