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Place of Service covered for Allergen Immunotherapy

The major risk of allergen immunotherapy is anaphylaxis; in rare cases, this can be fatal despite optimal management. Because most serious systemic reactions occur within 30 minutes after an injection, patients should remain in the physician’s office/medical clinic for at least 30 minutes after the immunotherapy injection. Therefore, allergen immunotherapy should be administered in a setting where anaphylaxis will be promptly recognized and treated by a physician or NPP appropriately trained in emergency treatment. For the safe and effective administration of allergen immunotherapy, the physician and personnel administering immunotherapy should be aware of the technical aspects of this procedure and have available appropriately trained personnel and resuscitative equipment/medicines. Evidence of such compliance should be documented and maintained in personnel files.

Home administration will only be considered in rare and exceptional cases when allergen immunotherapy cannot be administered in a medical facility and the benefit of allergen immunotherapy clearly outweighs the risk (e.g., VIT for a patient living in a remote area). Informed consent must be obtained from the patient. The person administering the injection to the patient must be educated about how to administer allergen immunotherapy and recognize and treat anaphylaxis. Recognition and treatment of an anaphylactic reaction might be delayed or less effective than in a clinical setting in which personnel, medications, supplies, and equipment are more optimal to promptly recognize and treat anaphylaxis. Frequent or routine prescription of home allergen immunotherapy is not appropriate. These rare cases will be reviewed through the individual consideration process with documentation review.

See Also:

Guidelines for Allergy Immunotherapy

Covered ICD lists

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