Summary & Overview

CPT 95145: Preparation of Stinging Insect Venom Extract Doses

CPT code 95145 captures the clinical service of mixing and preparing a specified number of doses of extract from a single stinging insect venom for use in venom immunotherapy. This preparation is a critical step in allergen immunotherapy workflows, supporting treatment for patients with venom hypersensitivity and preventing systemic allergic reactions. Nationally, accurate coding for extract preparation affects clinical documentation, inventory control, and claim adjudication for allergy services.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for venom extract preparation, typical sites of service, and the role this code plays in billing and service lines. The publication outlines benchmarks and reimbursement considerations where available, highlights coding relationships to related allergy services, and summarizes policy and coverage themes that influence claim acceptance and clinical workflow. Data not provided in the input are noted as unavailable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare95145CPTvenom immunotherapyallergyallergen extract preparationoutpatientambulatory careallergy clinic

Billing Code Overview

CPT code 95145 describes the preparation of a specified number of doses of extract derived from a single stinging insect venom. This service involves the mixing and preparation of allergen extract doses for immunotherapy using venom from a single insect species.

Service type: Allergen extract preparation for venom immunotherapy
Typical site of service: Allergy clinic, outpatient infusion or procedure area, or other ambulatory care setting where venom immunotherapy is administered

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with a documented systemic hypersensitivity to stinging insect venom (for example, a history of anaphylaxis after a bee or wasp sting) who is undergoing venom immunotherapy. The clinical workflow begins with a consultation by an allergist/immunologist who documents the indication, obtains informed consent, and prescribes a standardized venom extract series. At the treatment visit, nursing staff or the provider mixes and prepares a specified number of doses of a single stinging insect venom extract (Apis mellifera, Vespidae, etc.) according to the clinic’s protocol and manufacturer instructions. Prepared doses are labeled, stored appropriately, and either administered during the same visit or prepared for a series of outpatient injections scheduled over weeks to months for build-up and maintenance phases. Typical site of service is an outpatient clinic or physician office equipped for allergy immunotherapy; preparation may occur in the clinic pharmacy or treatment room under provider or pharmacist supervision. Billing uses 95145 to report the mixing/preparation of the specified number of doses of a single stinging insect venom extract when performed by the provider or qualified clinical staff.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when only the physician work (interpretation or supervision) is billed separate from technical components; seldom used for extract prep alone.
`51`	Multiple procedures	Use when multiple distinct services are billed on the same day and payer requires modifier for bundling considerations.
`52`	Reduced services	Use when the preparation is partially performed or limited compared with standard service.
`53`	Discontinued procedure	Use when preparation is started but discontinued for patient safety or other reasons.
`59`	Distinct procedural service	Use when an unrelated procedure is performed on the same day and the venom extract preparation is separate and distinct.
`62`	Two surgeons	Use when two surgeons of different specialties are required; rarely applicable but included for completeness.
`78`	Return to OR for related procedure during postoperative period	Rare for this service; used only if subsequent related operative work occurs.
`80`	Assistant surgeon	Use when an assistant surgeon participates; uncommon for extract preparation but applicable if surgical setting involvement occurs.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services	Use when the service is performed by a qualified non-physician practitioner eligible under payer rules.
`QX`	Service performed by an individual practitioner with QP status for modifier reporting	Use when applicable to compliant reporting of practitioner-specific services.

Taxonomy Code	Specialty	Notes
207K00000X	Allergy & Immunology	Board-certified allergists who manage venom immunotherapy and supervise extract preparation.
2084P0800X	Pediatric Allergy & Immunology	Specialists who perform venom immunotherapy in pediatric patients when indicated.
207R00000X	Clinical Pharmacology	Clinical pharmacists who mix and prepare allergen extracts in clinic pharmacies under protocol.
363LP0200X	Licensed Practical Vocational Nurse	Nursing staff who assist with preparation and labeling under supervision.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`T63.441A`	Hornet venom poisoning, accidental (unintentional), initial encounter	Indicates systemic reaction to hornet sting prompting venom immunotherapy consideration.
`T63.441D`	Hornet venom poisoning, accidental (unintentional), subsequent encounter	Follow-up encounters after initial sting-related reaction; may be part of immunotherapy planning.
`T63.441S`	Hornet venom poisoning, accidental, sequela	Late effects of hornet envenomation that may be managed in context of venom allergy.
`T63.421A`	Wasp venom poisoning, accidental (unintentional), initial encounter	Wasp sting anaphylaxis history commonly leads to venom extract preparation for immunotherapy.
`T63.411A`	Bee venom poisoning, accidental (unintentional), initial encounter	Bee sting systemic reaction is a primary indication for venom immunotherapy using `95145` preparations.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`95115`	Professional services for allergen immunotherapy not including provision of allergenic extracts; single or multiple antigens, initial to maintenance dose, per visit	Billed for the injection visit when the immunotherapy injection is administered following preparation of venom extract; documents patient management and injection services.
`95146`	The provider mixes and prepares a specified number of doses of extracts of multiple stinging insect venoms	Billed when more than one stinging insect venom extract is mixed/prepared during the same encounter instead of `95145`.
`95144`	Professional services for preparation of allergenic extracts (single or multiple) — extract mixing/compounding codes for non-stinging insect antigens	Used when preparing non-venom allergen extracts; differentiates venom from other allergen mixes.
`96401`	Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic	Rarely associated but included when specialized injectables are administered in parallel; typically not used for venom immunotherapy.
`99070`	Supplies and materials (e.g., gloves, syringes) provided by the physician over and above those usually included with the office visit	Used to report additional non-routine supplies required for extract preparation or administration when payer allows.