Answer: Yes, you may report the physician services in addition to any applicable injection code(s) (e.g., 95115, Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection or 95120, Professional services for allergen immunotherapy in prescribing physicians office or institution, including provision of allergenic extract; single injection). As in other cases when an E/M service is provided at the same time as a procedure, modifier -25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) must be appended to the E/M code.
Generally, the physician will treat the patient with epinephrine (which is billable using HCPCS supply code J0170) and report a standard established patient E/M service (e.g., 99214, Office or other outpatient visit for the evaluation and management of an established patient). If the situation warrants the physician may access the critical care (99292-99292) or prolonged services codes (99354-99357) along with other, separately reportable services (e.g., 31500, Intubation, endotracheal) as required. In all cases, documentation should clearly explain the patient's condition to substantiate the necessity of reporting the additional E/M code(s).
