Summary & Overview
CPT 95133: Stinging Insect Venom Immunotherapy, Office Administration
CPT code 95133 denotes in-office administration of stinging insect venom immunotherapy for four insect species, a targeted treatment to prevent or reduce systemic allergic reactions in venom-allergic patients. This procedure is clinically important nationwide because venom immunotherapy is the only disease-modifying therapy proven to reduce the risk of severe anaphylaxis from insect stings and can substantially improve patient safety and quality of life.
Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service settings, typical payer coverage considerations, common billing modifiers, and where to locate relevant benchmarks and policy updates. The publication also summarizes coding nuances, site-of-service implications, and the role of CPT code 95133 within allergen immunotherapy workflows.
This resource is intended for clinicians, billing professionals, and policy analysts seeking a national perspective on coding and administrative considerations for stinging insect venom immunotherapy administered in the office setting. Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Billing Code Overview
CPT code 95133 describes in-office administration of stinging insect venom immunotherapy for four types of insects to treat or prevent allergic reactions in sensitized patients. The service involves the provider administering venom extracts specific to identified insect species as part of an immunotherapy regimen.
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Service type: Allergen immunotherapy administration (stinging insect venom)
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Typical site of service: Office-based setting (physician or allergy clinic)
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult or pediatric individual with a documented systemic allergic reaction or significant local reactions to stinging insect stings and positive skin testing or specific IgE confirming sensitization to hymenoptera venom. The patient presents to an allergy clinic or outpatient physician office for supervised venom immunotherapy (VIT). The provider reviews history, confirms indication (prior anaphylaxis or large local reactions with positive testing), obtains informed consent, and verifies availability of emergency medications and resuscitation equipment. The visit includes baseline vital signs, assessment for acute illness that would contraindicate dosing, and administration of venom extracts for up to four insect types (for example honeybee, yellow jacket, paper wasp, and hornet). The patient is observed on site for the recommended post-injection monitoring period (commonly 30 minutes) for systemic reactions. Documentation includes indication, lot numbers and concentrations of venom used, dose administered, route (subcutaneous), injection site, any immediate reactions, post‑procedure instructions, and emergency interventions if required. The typical site of service is an outpatient allergy/immunology clinic or physician office equipped for immunotherapy and emergency management.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | An institutional or payer-specific modifier reserved for use by some systems | Use only if required by the payer's billing rules (rare) |