Primary Care Coding Alert

Question: When a patient who requires immuno-therapy brings in serum for his biweekly allergy injection, my office reports 95115 for giving the injection and monitoring the patient. A new coder says that we should instead use 95120. What is the distinguishing difference between these injection codes?

Mississippi Subscriber 
 
Answer: In this instance, you are correct that you should use 95115 (Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection).
 
The difference between the codes is that 95120 (Professional services for allergen immunotherapy in prescribing physician's office or institution, including provision of allergenic extract; single injection) includes the allergenic extract provision, but 95115 doesn't. Code 95115 instead describes injection administration without serum provision. Both codes include professional services, such as monitoring the patient for an adverse reaction, necessary for allergen immunotherapy.
 
Since your example describes a patient who brings in his serum, you would use 95115 in this instance. If your family physician provided the serum, you  would instead report 95120.