Summary & Overview
CPT 95149: Preparation of Five-Sting Insect Venom Extracts
CPT code 95149 identifies the clinical service of mixing and preparing multiple doses of extract from five single stinging insect venoms for use in venom immunotherapy. This procedure is important nationally because it supports the safe, standardized delivery of allergen extracts used to prevent severe allergic reactions to stinging insects, a public health concern for individuals with venom hypersensitivity.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context and service setting for CPT code 95149, typical payer coverage considerations, and what to expect in benchmarking and policy interpretation. The publication outlines how this preparation service fits into the broader venom immunotherapy care pathway, common billing modifiers and service line considerations (listed separately), and notes where input data was not provided.
This national summary equips administrators, billing professionals, and policy analysts with clear context about the service represented by CPT code 95149, how it is typically delivered, and which major payers are relevant for coverage and claims processing discussions.
Billing Code Overview
CPT code 95149 describes the provider service of mixing and preparing a specified number of doses of extract of five single stinging insect venoms. This service is a preparation step for allergen immunotherapy targeting insect venom hypersensitivity.
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Service type: Allergen extract preparation for multi-venom immunotherapy
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Typical site of service: Allergy clinic, outpatient infusion or procedure area, or physician office where venom immunotherapy is administered
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a history of systemic allergic reactions to stinging insects (honeybee, yellow jacket, hornet, wasp, and fire ant) who is undergoing maintenance or initiation of venom immunotherapy. The patient presents to an outpatient allergy/immunology clinic or hospital outpatient infusion center for preparation of multivalent venom extract doses. The clinical workflow begins with a physician or certified allergist evaluating the patient’s history, confirming prior systemic reaction and relevant testing (skin test or serum specific IgE). An order is placed for mixing and preparing a specified number of doses of extract containing five single stinging insect venoms. A licensed provider or trained clinical pharmacist compounds the extracts under aseptic technique, labels doses with concentration and expiration, and documents lot numbers and vial numbers. Prepared doses are then transferred to the clinical team for administration by a nurse or qualified clinician during supervision of the allergist. Billing uses 95149 for the mixing/preparation service; administration and observation are reported separately using appropriate CPT codes. Typical site of service is an outpatient clinic, physician office, or hospital outpatient infusion/ambulatory care center.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Principal procedure | Use when this mixing/preparation is the primary service performed during the encounter. |