Pediatric Coding Alert

Reader Questions:

Take a Shot at Coding This Allergy Immunization Encounter When Serum not Provided

Question: If a patient comes to us asking to administer an allergy injection and brings her own serum, is it possible to report the shot without a supply code?

Florida Subscriber

Answer: Yes. If your pediatrician only administers the allergy injection, you will use 95115 (Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection) or 95117 (… 2 or more injections) depending on the number of injections your provider administers.

Remember: Both codes include professional services, such as monitoring the patient for an adverse reaction, which are necessary for allergen immunotherapy. So, if the injection is the only service your pediatrician provides at the encounter, you would not be able to bill for additional office/outpatient evaluation and management (E/M) services for observing and monitoring the patient for anaphylactic shock after the injection.