Pediatric Coding Alert

Question: When we administer allergy injections with patient-supplied allergenic extract, we submit CPT 95115 or 95117. May we also report an administration fee with 90471?

Illinois Subscriber

Answer: No, you should report only 90471 (Immunization administration [includes percutaneous, intradermal, subcutaneous, intramuscular and jet injections]; one vaccine [single or combination vaccine/toxoid]) in addition to a vaccine and toxoid code (90476-90749), according to CPT's note introducing the "immunization administration for vaccines/toxoids" section.

When you provide allergy immunotherapy, you're not administering a vaccine or toxoid. You're instead injecting allergenic extract, so you should submit the appropriate allergen immunotherapy administration code based on whether you administer one injection (95115, Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection) or two or more (95117, ... two or more injections).

These codes include the "professional services necessary for allergen immunotherapy," CPT states. So you shouldn't submit a separate allergy injection administration code.