Primary Care Coding Alert

You Be the Coder:

Best Injection Choice for Allergy Shot

Question:

Our office orders allergy serum for patients, which the patients pay up for up front. When the patient comes in for the allergy injection, the previous coder would submit CPT 96372 for administration because the office had already been paid for the serum. I think the office should be reporting 95115 or 95117 instead. What's the best answer?

Iowa Subscriber

Answer:

You are correct in thinking that 96372 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular) isn't the best code choice in this situation. The patient does receive an injection, but CPT includes codes that better describe allergy injections.

The better choice is to report 95115 (Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection) for a single injection and 95117 (...2 or more injections) if your provider administers two or more allergy shots.

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