# Allergy injections



## smeetze

Help! Pt brings allergy serum to our family practice office.  Pt comes in once every two weeks for us to give them their allergy injections from the serum they left with us..... What CPT do we charge?


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## donsqueen

If it was given by a non-physician then just the administration code. If there was also an office visit then that MAY be billable as well.


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## Donag

*allergy injections*

y ou would use cpt code 95115 if single injection administered  if 2or more use 95117


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## smeetze

The codes above specifically say professional services for allergen immunotherapy(physician injects).  This is my delima. Do I use administrative codes or the 95115/95117?


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## Lisa Bledsoe

Forgive me, but where does it state "physician injects"?


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## smwermter

I agree with Donag.  95115 or 95117 depending on the number of injections are the codes we use at our clinics.


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## smeetze

In our encoder pro it  says "physician injects" in the lay description but in the CPT book it says "Professional Services".  This is where I am second guessing myself.  Thanks for all of your help!


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## Anna Weaver

*allergy injections*

Here's what CPT assistant has to say:

 	Allergy injections and diagnostic tests 
	CPT Assistant, December 2007 Page: 9   Category: Coding Consultation
CPT Coding for Allergy Injections and Allergy Diagnostic Tests 

Allergy Injections

Allergy injections are reported using CPT codes 95115 for a single injection and 95117 for two or more injections. These codes describe the administration (injection) of the allergenic extract when the extract provision or preparation of the extract is not included in the code descriptor. They do not include the provision or preparation of the extract. Codes 95115 and 95117 are intended to be reported one time, regardless of the number of injections administered. These services are typically performed by a nurse and do not include physician work. If the physician performs an evaluation and management (E/M) service on the same day as an injection, the physician should document the service and report the appropriate level E/M service code. In cases when there is no physician history or exam performed but the nurse must consult with the physician as to whether the patient should receive the injection and whether dosage adjustments are required (eg, the patient is ill or reports a reaction to the last injection), CPT code 99211 would be appropriate.

Allergy Diagnostic Tests

95004 Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction, including test interpretation and report by a physician, specify number of tests

95024 Intracutaneous (intradermal) tests with allergenic extracts, immediate type reaction, including test interpretation and report by a physician, specify number of tests

95027 Intracutaneous (intradermal) tests, sequential and incremental, with allergenic extracts for airborne allergens, immediate type reaction, including test interpretation and report by a physician, specify number of tests

Effective January 1, 2008, the descriptors for the allergy diagnostic test codes (CPT codes 95004, 95024, and 95027) have been modified to clarify that the service includes "test interpretation and report by a physician." In addition, Centers for Medicare & Medicaid Services (CMS) now recognizes physician work for CPT codes 95004, 95024, and 95027. Furthermore, the Allergy and Clinical Immunology guidelines have been modified to indicate that when reporting any allergy testing on the same day as a significant, separately identifiable E/M service, modifier 25 must be appended to the E/M service code.




CPT Assistant © Copyright 1990–2008 American Medical Association. All Rights Reserved 

Maybe this will help?


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## Lisa Bledsoe

If you are giving the allergy shot(s) from a pre-mixed vial, you will code 95115for one shot or 95117 for two or more.


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## smeetze

Thank you so much for all your help! I think you all have helped me with my question!

Thank you again.
Stephanie


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## Lana Ness

For 95004 I understand that they changed the verbiage in 2008 to include interpretation and report. Does this mean that there needs to be a separate interpretation and report by the physician, not just a sentence within the medical note for that date of service? Thanks


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## bziegman

*Billing*

What admin code would you use?




Anna Weaver said:


> Here's what CPT assistant has to say:
> 
> Allergy injections and diagnostic tests
> CPT Assistant, December 2007 Page: 9   Category: Coding Consultation
> CPT Coding for Allergy Injections and Allergy Diagnostic Tests
> 
> Allergy Injections
> 
> Allergy injections are reported using CPT codes 95115 for a single injection and 95117 for two or more injections. These codes describe the administration (injection) of the allergenic extract when the extract provision or preparation of the extract is not included in the code descriptor. They do not include the provision or preparation of the extract. Codes 95115 and 95117 are intended to be reported one time, regardless of the number of injections administered. These services are typically performed by a nurse and do not include physician work. If the physician performs an evaluation and management (E/M) service on the same day as an injection, the physician should document the service and report the appropriate level E/M service code. In cases when there is no physician history or exam performed but the nurse must consult with the physician as to whether the patient should receive the injection and whether dosage adjustments are required (eg, the patient is ill or reports a reaction to the last injection), CPT code 99211 would be appropriate.
> 
> Allergy Diagnostic Tests
> 
> 95004 Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction, including test interpretation and report by a physician, specify number of tests
> 
> 95024 Intracutaneous (intradermal) tests with allergenic extracts, immediate type reaction, including test interpretation and report by a physician, specify number of tests
> 
> 95027 Intracutaneous (intradermal) tests, sequential and incremental, with allergenic extracts for airborne allergens, immediate type reaction, including test interpretation and report by a physician, specify number of tests
> 
> Effective January 1, 2008, the descriptors for the allergy diagnostic test codes (CPT codes 95004, 95024, and 95027) have been modified to clarify that the service includes "test interpretation and report by a physician." In addition, Centers for Medicare & Medicaid Services (CMS) now recognizes physician work for CPT codes 95004, 95024, and 95027. Furthermore, the Allergy and Clinical Immunology guidelines have been modified to indicate that when reporting any allergy testing on the same day as a significant, separately identifiable E/M service, modifier 25 must be appended to the E/M service code.
> 
> 
> 
> 
> CPT Assistant © Copyright 1990–2008 American Medical Association. All Rights Reserved
> 
> Maybe this will help?


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