Reader Question:
Allergy Immunotherapy
Published on Mon Dec 31, 2012
Question: What are the administration and CPT codes for allergy immunotherapy? What are the guidelines for using them? Tennessee Subscriber Answer: The pulmonologist must be in the office when the injection is given, and a statement documenting this must be provided in Box 31 of the CMS-1500 form.
Codes that apply to immunotherapy include 95115-95199. Two specific codes billed to Medicare are allowed for injection services (95115 and 95117). Codes 95115 and 95117 are for injections only and do not include antigen provision (95120-95134; 95144; 95165). The office that administers the injection bills 95115 or 95117. The extract or antigen provision codes are billed by the office that prepares the injection therapy. The injection codes include 30 minutes of physician supervision to monitor for an allergic reaction. The codes also preclude a pulmonologist's office from billing a separate E/M code for the visit by appending modifier [...]
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