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Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; whole body extract of biting insect or other arthropod (specify number of doses)

CPT4 code

Name of the Procedure:

Professional Services for the Supervision of Preparation and Provision of Antigens for Allergen Immunotherapy; Whole Body Extract of Biting Insect or Other Arthropod (specify number of doses)

Summary

This procedure involves the preparation and administration of allergens derived from insects or other arthropods to a patient under the supervision of a healthcare professional. This form of immunotherapy is designed to decrease sensitivity to specific allergens over time.

Purpose

The primary goal is to reduce or eliminate allergic reactions to biting insects or arthropods. By exposing the patient to controlled doses of the allergen, the immune system becomes less reactive, thereby preventing potentially severe allergic reactions.

Indications

Indicated for patients who have a history of allergic reactions to insect bites or stings, such as hives, swelling, or anaphylaxis. It is particularly appropriate for individuals with severe or life-threatening reactions, or those who frequently encounter these allergens.

Preparation

  • Patients may be advised to avoid certain medications (e.g., antihistamines) before the procedure.
  • Diagnostic tests, such as skin testing or blood tests, may be conducted to identify specific allergens.
  • Patients should inform their healthcare provider about their medical history and any existing health conditions.

Procedure Description

  1. Under the supervision of a healthcare provider, specific doses of insect or arthropod extracts are prepared.
  2. The patient receives these allergens through injections, typically starting with very small amounts.
  3. The dose is gradually increased over time according to a tailored schedule.
  4. The patient’s response is monitored closely throughout the procedure to manage any adverse reactions.

This procedure uses syringes and needles or sometimes alternate delivery devices. Anesthesia is not typically required but may be used in certain cases to minimize discomfort.

Duration

The initial appointment can last about 30 minutes to an hour. Subsequent sessions are often shorter, approximately 15-30 minutes each.

Setting

Performed in an outpatient clinic, allergy specialist's office, or a medical center equipped to handle allergic emergencies.

Personnel

  • Allergist or immunologist
  • Nurse or medical assistant
  • Potential presence of emergency personnel or tools for severe allergic reactions

Risks and Complications

  • Common: Local reactions like redness, swelling, or itching at the injection site.
  • Rare: Systemic reactions including hives, difficulty breathing, or anaphylaxis, which require immediate medical attention.

Benefits

  • Significant reduction or complete elimination of allergic reactions to specific insect or arthropod bites or stings.
  • Improved quality of life and less anxiety about encountering these allergens.

Benefits can often be realized within a few months of starting the therapy, although continued treatment over several years may be necessary for lasting results.

Recovery

  • Patients may be observed for 30 minutes after each injection for immediate reactions.
  • They may experience mild symptoms like swelling or soreness at the injection site.
  • Regular follow-up appointments are required to monitor progress and adjust dosages.

Alternatives

  • Avoidance strategies to minimize exposure to biting insects or arthropods.
  • Medications like antihistamines or corticosteroids to manage allergic reactions.
  • Emergency epinephrine injectors for severe reactions.

Each alternative has its pros and cons compared to immunotherapy, such as varying effectiveness and convenience.

Patient Experience

  • Slight pain or discomfort from injections is common.
  • After the procedure, patients may experience temporary soreness or mild swelling.
  • Pain management can include over-the-counter pain relievers and ice packs.

Immunotherapy can be life-changing for those suffering from severe allergies, enhancing overall well-being and reducing constant worry regarding future allergic reactions.

Medical Policies and Guidelines for Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; whole body extract of biting insect or other arthropod (specify number of doses)

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