Allergy and Immunology Billing Services

Allergy and Immunology Billing Services

Allergy and immunology billing services require specialized knowledge of diagnostic testing procedures, immunotherapy treatments, and payer-specific reimbursement policies. Allergy testing, serum preparation, and immunotherapy injections involve multiple CPT codes, dosage structures, and documentation requirements that must be accurately recorded for proper claim submission.

Common CPT Codes Used in Allergy and Immunology Billing

Allergy and immunology billing frequently relies on CPT codes related to allergy testing and immunotherapy treatments, each with its own documentation standards and payer policy considerations.

• 95004 – Percutaneous Testing: Skin prick testing for multiple allergens.
• 95024 – Intracutaneous Testing: Intradermal allergy testing.
• 95044 – Patch Testing: Testing for contact allergen sensitivity.
• 95115/95117 – Immunotherapy Injections: Single or multiple allergen immunotherapy injections.
• 95165 – Serum Preparation: Preparation of allergen extract for immunotherapy.

Documentation & Payer Authorization Requirements

Clinical documentation supports the medical necessity of every service billed — allergy testing results, individualized treatment and immunotherapy plans, serum preparation records, injection administration, and patient progress monitoring. Billing requirements vary by testing type, number of allergens tested, immunotherapy dosage phase, patient eligibility criteria, and Medicare or commercial payer coverage policy.

MBW RCM brings specialty-focused expertise to allergy and immunology billing — accurate testing and immunotherapy coding, serum preparation and dosage tracking, authorization management, and denial analysis tied to testing frequency limits and payer-specific policies. Our team coordinates documentation, coding accuracy, and claim follow-up into a single, compliant revenue cycle workflow.