I am needing some clarification due to a patient account issue. We have always billed 95115 and 95117 with the appropriate diagnosis (allergic rhinitis,allergic asthma etc). This particular patient's insurance will not cover medical conditions but will cover preventative care. In researching this, I have found that there is a V code for desensitization of allergens, which is V07.1. My question is, should we be using the V code for our allergy injection patients, or have we been coding correctly. I appreciate any thoughts or help on this!!
Miscellaneous V codes
The miscellaneous V codes capture a number of other health care encounters that do not fall into one of the other categories. Certain of these codes identify the reason for the encounter, others are for use as additional codes that provide useful information on circumstances that may affect a patient’s care and treatment.
When a patient is coming to the office to receive routine allergy shots you should use the appropriate allergy code followed by V07.1
For instance, a patient receives immunotherapy for dust, cats and pollen. Allergies are considered chronic conditions - the condition still exists even though the patient is not having acute symptoms. You should report the appropriate diagnosis for each allergy. For the dust and cat dander, use 477.8 (Allergic rhinitis; due to other allergen). For the pollen allergy, assign 477.0 (... due to pollen). List V07.1 last.
If you don't know what allergies the patient is being treated for then it would be appropriate to report V07.1 as the primary diagnosis.