Allergy Injection CPT Codes Guide

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Allergy Injection CPT Codes: A Comprehensive Guide

Accurate and precise coding for allergy injections is crucial for healthcare providers and coders. This blog aims to demystify the process by providing a clear understanding of commonly used CPT codes.

Struggling with denied claims? You might be using the wrong ICD-10 codes. These codes aren’t just numbers — they tell the patient’s story. From chronic conditions to one-time injuries, ICD-10 codes help translate medical records into billable claims. Learning how to use them effectively can improve both coding accuracy and cash flow.



Allergy Injection CPT Codes Explained

Allergy immunotherapy, often referred to as allergy shots, is a common treatment for allergies. The CPT codes used for these procedures vary depending on the specific services provided. Here's a breakdown of some frequently used codes:

  • CPT code 95180: This code is typically used for the administration of a single allergen extract injection. It's important to note that this code doesn't include the preparation or supply of the extract.
  • CPT code 95165: This code covers the supervision of allergen extract preparation and provision for immunotherapy. It's often used in conjunction with other codes, such as those for the actual injection. The maximum units allowed for CPT 95165 can vary based on payer guidelines (e.g., Aetna 95165 limits).
  • CPT code 95117: This code is for the professional administration of multiple allergen extract injections. It doesn't include the preparation or supply of the extract.
  • CPT code 95144: This code describes the allergist's preparation and provision of single-dose vials for administration by another physician.
  • CPT codes 95120-95134: These codes describe complete service codes for the combined supply of antigen AND allergy injection provided during a SINGLE encounter.  

Additional Considerations

  • Allergy immunotherapy administration of antigen only cpt code: While there isn't a specific CPT code solely for the administration of antigen, it's typically included in the overall service provided and would be billed using the appropriate code based on the services rendered.
  • Payer-specific guidelines: It's essential to consider payer-specific rules and regulations when determining the correct CPT code and number of units. Payers often have specific requirements for allergy injection codes, including documentation and medical necessity.


When to Use Which Code

Determining the correct CPT code depends on several factors, including:

  • Whether the provider prepares the allergen extract or receives it from an external source.
  • The number of injections administered during the visit.
  • The specific allergen being used.
  • Payer-specific guidelines and requirements.

It's essential to refer to the official CPT codebook for the most accurate and up-to-date information.

Tips for Accurate Coding

  • Document thoroughly: Detailed and accurate documentation is crucial for proper code selection and reimbursement.
  • Stay updated: CPT codes are subject to changes. Keep yourself informed about the latest updates.
  • Utilize coding resources: There are numerous resources available to assist with CPT code selection.
  • Understand payer guidelines: Familiarize yourself with payer-specific rules and requirements for allergy injection codes.

By following these guidelines and understanding the specific details of each CPT code, providers and coders can improve their accuracy and efficiency.

For reliable and expert medical billing services, consider partnering with HMS USA LLC, a leading provider in the industry.

Location: United States

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