95133 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; 4 stinging insect venoms

Name of the Procedure:

Professional Services for Allergen Immunotherapy for Stinging Insect Venoms

• Common Name: Stinging Insect Venom Allergy Shots
• Technical Term: Allergen Immunotherapy for Hymenoptera Venom

Summary

Allergen immunotherapy for stinging insect venoms involves introducing small, controlled doses of the venom to an allergic individual to build immunity over time. This procedure aims to reduce the severity of allergic reactions to insect stings.

Purpose

Allergen immunotherapy for stinging insect venoms addresses serious allergic reactions to insect stings, such as from bees, wasps, hornets, or yellow jackets. The goal is to desensitize the patient's immune system to these venoms, reducing the risk of life-threatening allergic reactions (anaphylaxis) in the future.

Indications

• History of severe allergic reactions (anaphylaxis) to stinging insect venom
• Positive skin or blood test indicating an allergy to stinging insect venom
• Patients who have had systemic reactions and are at risk of future stings

Preparation

• Avoid taking antihistamines for a specified period before the procedure, as directed by your healthcare provider
• Ensure all relevant medical history and allergy tests are up to date
• No fasting is typically required

Procedure Description

1. The healthcare provider prepares the allergenic extract, which contains venom from four types of stinging insects.
2. The patient receives a series of injections, typically starting with very small doses.
3. Doses are gradually increased over time, during the build-up phase, which may last several months.
4. Once the maintenance dose is reached, injections continue at regular intervals over a period of 3-5 years.
5. Vital signs are monitored during and after the injection for any adverse reactions.

Duration

• Each injection appointment usually takes about 30 minutes, including a waiting period for monitoring.
• The build-up phase can last several months, with maintenance therapy continuing for 3-5 years.

Setting

The procedure is performed in the office or institution of the prescribing physician or another qualified healthcare professional.

Personnel

• Allergist or Immunologist
• Nurse or Medical Assistant

Risks and Complications

• Common: Local reactions at the injection site (redness, swelling, itching)
• Rare: Systemic allergic reactions, including anaphylaxis, which require immediate medical attention

Benefits

• Significant reduction in the severity of allergic reactions to stinging insects
• Improved quality of life and reduced anxiety about outdoor activities
• Benefits are typically realized within the first year of treatment

Recovery

• Patients are observed for about 30 minutes after each injection for any adverse reactions
• Normal activities can usually be resumed shortly after the observation period
• Follow-up appointments are necessary to adjust doses and monitor progress

Alternatives

• Avoidance of known stinging insects
• Emergency self-injectable epinephrine for immediate treatment of allergic reactions
• Alternatives do not provide the long-term desensitization benefit of allergen immunotherapy

Patient Experience

• Patients may experience mild discomfort from the injection
• Temporary localized swelling and itching are common
• Pain management includes applying ice and using analgesics if needed
• The reassurance of ongoing medical supervision during the treatment period