Allergy Immunotherapy Update (May 1996)

May 1996 pages 1-2 Allergy Immunotherapy Update This is the time of the year when spring is in the air, the sun shines brightly, and everyone is outdoors-well, almost everyone. Unfortunately, along with the glories of spring also come pollen and other allergens, just waiting to wreak havoc on those individuals who suffer each year with allergies. In keeping with the season, we present an overview of the Allergen Immunotherapy codes as they appear in CPT 1996. This article will serve to update two previous articles (Fall 1991 and Spring 1994). Allergen Immunotherapy Not Including Extracts Codes 95115 and...

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Note:  The following article synopsis was NOT provided by the AMA. It was created by Find-A-Code/innoviHealth.

Article Overview

This article reviews allergen immunotherapy coding guidance as reflected in CPT 1996. It explains the general scope of immunotherapy services, discusses revisions affecting how injections and antigen preparation are reported, and includes clinical vignettes that illustrate common reporting scenarios. The content is most relevant to coders, allergists, and billing staff working with allergy services and E/M reporting.

Why This Topic Matters

Allergen immunotherapy coding can involve multiple service components and different reporting situations depending on where the service is provided and whether extract preparation is included. This update helps readers understand the scope of the CPT 1996 changes and the kinds of encounters that may require careful code selection.

Article Sections

  1. Allergen Immunotherapy Not Including Extracts

    Covers the general reporting framework for immunotherapy administration when extract provision is not part of the reported service. It also notes CPT 1996 wording changes affecting how injection services are described.

  2. Allergen Immunotherapy in Prescribing Physician's Office

    Describes immunotherapy services furnished in the prescribing physician setting and discusses how preparation and administration may be grouped in that context. It also addresses the reporting of services involving different venom preparations.

  3. Provision of Antigens (Allergenic Extracts)

    Reviews reporting for antigen preparation and provision when extracts are supplied for use by another physician. It also explains the broader family of antigen-provision codes and the types of preparation they represent at a high level.

  4. Office Visits in Conjunction with Allergen Immunotherapy

    Summarizes when a separate office or outpatient visit may be considered alongside immunotherapy. The section focuses on the relationship between immunotherapy and other identifiable services.

  5. clinicalvignettes

    Presents example scenarios showing how the immunotherapy guidance is applied in practice. The examples illustrate combinations of preparation, administration, and evaluation services.

What You Will Learn

  • How allergen immunotherapy services are categorized in CPT 1996
  • How the article organizes administration, preparation, and provision concepts
  • What changed in the wording of selected immunotherapy code language
  • When office or outpatient evaluation services may be discussed with immunotherapy
  • How the article uses clinical vignettes to illustrate reporting scenarios

Who Should Read This

  • Medical coders
  • Allergy and immunology practices
  • Physicians who bill immunotherapy services
  • Billing and reimbursement staff
  • Compliance and coding educators

Codes Discussed

  • CPT: 95115
  • CPT: 95117
  • CPT: 95125
  • CPT: 95120
  • CPT: 95130
  • CPT: 95131
  • CPT: 95132
  • CPT: 95133
  • CPT: 95134
  • CPT: 95144
  • CPT: 95145
  • CPT: 95146
  • CPT: 95147
  • CPT: 95148
  • CPT: 95149
  • CPT: 95165
  • CPT: 95170

Code Ranges Discussed

  • CPT: 95120 through 95134
  • CPT: 95144-95170
  • CPT: 95145-95170
  • CPT: 95145-95149
  • CPT: 95165-95170

Modifiers Discussed

  • CPT: -25

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