Otolaryngology Coding Alert

Question: A patient who requires immunotherapy due to hay fever brings in serum for his biweekly allergy injection. Which CPT code(s) should I use for giving the injection and monitoring the patient?

New Hampshire Subscriber

Answer: Because your office provides the injection administration only, you should report 95120 (Professional services for allergen immunotherapy in prescribing physician's office or institution, including provision of allergenic extract; single injection). This code includes providing the shot and monitoring the patient for any adverse reactions.
 
Don't separately report an office visit unless the nurse provides a significant, separately identifiable service. In this case, you would append modifier -25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) to the appropriate E/M code. You can code a nurse visit (99211, Office or other outpatient visit for the evaluation and management of an established patient ...) in situations such as the following: When a patient presents for his shot, he has a cough (786.2). The nurse evaluates him to make sure he is healthy enough to receive the shot. In this case, report 95120 and append modifier -25 to 99211 to indicate that the office visit is a significant, separately identifiable service from the injection.