95117 Professional services for allergen immunotherapy not including provision of allergenic extracts; 2 or more injections

Name of the Procedure:

Professional Services for Allergen Immunotherapy; 2 or More Injections
Common Name: Allergy Shots

Summary

Allergen immunotherapy, often referred to as allergy shots, is a procedure where small doses of allergens are injected into a patient to build up their immunity towards specific substances that trigger allergic reactions. This procedure involves two or more injections typically administered at regular intervals.

Purpose

Allergen immunotherapy aims to reduce or eliminate allergic reactions to substances such as pollen, dust mites, animal dander, and insect stings. By gradually exposing the immune system to the allergen, the body learns to tolerate it better, leading to fewer or less severe allergy symptoms.

Indications

• Persistent allergic rhinitis (hay fever) not controlled by medication
• Allergic asthma
• Severe reactions to insect stings
• Patients who experience year-round allergy symptoms
• Individuals for whom allergy medications are ineffective or cause side effects

Preparation

• Avoid strenuous activity immediately before and after injections.
• Inform the healthcare provider of any changes in your health, especially breathing problems or fever.
• May need to stop certain medications like beta-blockers, as recommended by the healthcare professional.

Procedure Description

1. Consultation and Testing: An allergist will assess the patient's allergy history and may conduct skin or blood tests to identify specific allergens.
2. Injection Preparation: The allergenic extract is prepared in a sterile manner.
3. Administration: The allergist administers small doses of the allergen through subcutaneous injections, typically into the upper arm.
4. Observation: After the injection, the patient will be monitored for 20-30 minutes to observe any immediate allergic reactions.
5. Dosing Schedule: Injections are typically given once or twice a week, with doses gradually increasing over time.

Duration

The initial visit for consultation and testing may take 1-2 hours. Each injection visit usually lasts about 30 minutes, including the observation period.

Setting

Allergen immunotherapy is typically performed in an outpatient clinic or an allergy specialist's office.

Personnel

• Allergist/Immunologist
• Registered Nurse or Medical Assistant

Risks and Complications

• Local reactions at the injection site (redness, swelling)
• Systemic reactions such as hives, low blood pressure, or anaphylaxis (rare)
• Respiratory reactions including asthma flare-ups

Benefits

• Reduced severity and frequency of allergic reactions.
• Decreased need for allergy medications.
• Improved overall quality of life, with benefits often becoming noticeable within 3 to 6 months.

Recovery

• Patients can resume normal activities shortly after the injections but should avoid vigorous exercise for several hours.
• Follow-up appointments are typically scheduled weekly or bi-weekly during the buildup phase, then every few weeks to monthly during the maintenance phase.

Alternatives

• Oral antihistamines, nasal sprays, and other medications
• Allergen avoidance strategies
• Sublingual immunotherapy (allergy drops) as an alternative for some allergens

Pros of Alternatives:

• Non-invasive
• Convenient for those who have difficulty frequenting a clinic.

Cons of Alternatives:

• May be less effective for severe allergies.
• Requires strict adherence and may have side effects.

Patient Experience

During the procedure, the patient might feel a slight prick from the needle and possibly some minor discomfort or itching at the injection site. After the injections, patients are observed for a short period to ensure no significant reaction occurs. Pain management typically includes ice packs or over-the-counter pain relievers if needed. Most patients tolerate the injections well and can return to their daily activities shortly after.