CPT 95165- allergy serum

Good Morning!
Does anyone have experience billing 95165 to Medicare? They only allow 30 units per day, but if a patient has multiple allergens it quickly adds up to more than 30 doses for the year.

They used to pay more if we separated it on two lines- now they are denying the entire claim if we bill more than 30 on the claim. Some allergy practices bill more than 30 doses on separate days, even though the serum was all mixed on one day. I'm wondering if there is any guidance on this.

Sabrina Gendreau
Billing & Coding

Comments

  • Hi my experience with code 95165 Medicare will only accept 10 units and Health Alliance Connect will accept only 40 units that will be paid.
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