Part B Coding Coach: Secure Allergen Immunotherapy Reimbursement That's Nothing to Sneeze At

Why This Topic Matters

Allergy claims can be denied when testing, preparation, injections, or office visits are coded inconsistently or without appropriate supporting information. Understanding the article’s scope helps readers determine whether they need guidance on payer coverage, CPT allergy testing and immunotherapy services, and same-day E/M billing.

Article Sections

1. Assess the Allergy Agony

   Introduces coverage and diagnosis considerations that may affect whether allergy-related services are supported. Includes discussion of payer variation and diagnosis categories used in relation to testing.

2. Administer Skin Testing

   Covers how allergy skin testing is approached and how testing services are categorized at a high level. Also addresses carrier-related considerations and additional follow-up testing concepts.

3. Prepare the Extract

   Focuses on preparation of antigens for immunotherapy and the role of dosage units in billing. Includes a payer policy example related to prepared doses.

4. Bill Number, Not Amount

   Explains the immunotherapy injection billing portion of the process and distinguishes it from earlier extract preparation billing. Describes the general reporting approach for injection services.

5. Append Modifier 25 To Same Day E/M

   Discusses same-day office or outpatient evaluation and management services alongside allergy testing or treatment. Includes general documentation and visit-sequencing considerations.