95132 Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 3 stinging insect venoms

Name of the Procedure:

Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 3 stinging insect venoms.

Summary

Allergen immunotherapy for stinging insect venoms, commonly known as venom immunotherapy (VIT), involves administering gradually increasing doses of venom extracts to a patient. This is done to reduce their allergic reactions to stinging insects like bees, wasps, and hornets.

Purpose

Venom immunotherapy addresses severe allergic reactions (anaphylaxis) caused by stings from specific insects. The goal is to desensitize the patient's immune system to the venom, significantly reducing the risk of severe reactions upon future stings.

Indications

• History of severe allergic reactions to insect stings.
• Positive skin test or blood test for insect venom allergies.
• High risk of repeated exposure to stinging insects (e.g., beekeepers, gardeners).

Preparation

• Patients may need to discontinue certain medications like beta-blockers or ACE inhibitors.
• An allergist may perform a skin test or blood test to confirm the specific insect venom allergies.
• Patients should inform their doctor of any existing medical conditions, including heart or lung diseases.

Procedure Description

1. Initial consultation and assessment by an allergist.
2. Venom extract is prepared for the patient.
3. Small doses of venom extract are injected subcutaneously (under the skin).
4. Doses are gradually increased over time, typically starting with weekly injections and moving to monthly maintenance doses.
5. Each injection session is monitored for adverse reactions, with emergency interventions available if needed.

Duration

Each injection session lasts about 30 minutes, but the entire course of therapy can span 3-5 years.

Setting

The procedure is performed in the office or institution of the prescribing physician or other qualified health care professional.

Personnel

• Allergist or immunologist
• Qualified nursing staff

Risks and Complications

• Local reactions at the injection site (e.g., redness, swelling)
• Systemic allergic reactions, including mild to moderate symptoms (e.g., hives, low blood pressure)
• Rarely, severe anaphylactic reactions requiring emergency treatment

Benefits

• Significant reduction in the risk of severe allergic reactions to stings.
• Improved quality of life and reduced anxiety related to insect stings.
• Desensitization effects can last many years after completing therapy.

Recovery

• Patients are observed for about 30 minutes post-injection for any adverse reactions.
• Normal activities can usually be resumed immediately after leaving the clinic.
• Regular follow-up appointments are required to monitor progress and adjust doses.

Alternatives

• Avoidance of insect exposure, though this can be impractical for many patients.
• Use of emergency epinephrine injectors (e.g., EpiPen) for immediate response to stings without desensitization.
• Oral antihistamines and steroids for managing mild allergic reactions.

Patient Experience

• Patients may feel mild discomfort or stinging from the injection.
• There might be some localized swelling or redness at the injection site.
• Pain management and comfort measures typically include topical anesthetics or cold packs if necessary.