Allergy & Immunology Medical Billing Services for Practices Across the USA
Allergy testing and immunotherapy billing for clinics and specialized practices.
Specialty highlight
99%
Built around payer rules, documentation requirements, and coding nuances.
Allergy Test Coding Accuracy
99%
Clean Claim Rate
96%
Allergy & Immunology Billing Services for Testing, Immunotherapy & Biologics
Allergy and Immunology billing is procedure-centric, revolving around allergy testing and the preparation and administration of immunotherapy. This area has very specific coding rules and is heavily scrutinized by payers. Our allergy billing service is designed to navigate this complex landscape, ensuring accurate coding for percutaneous and intradermal testing, correct billing for antigen preparation, and precise management of the multiple injections involved in immunotherapy, maximizing your revenue while maintaining strict compliance.
Allergy Skin Testing Coding
Accurate test-count-based coding for percutaneous scratch/prick testing (95004), intradermal testing (95017-95018), and patch testing (95044), with correct payer-specific panel limits and test-number verification.
Antigen Preparation & Vial Billing
Precise dose-based billing for allergy extract preparation (95144-95170) distinguishing single-antigen and multi-antigen vials, with correct unit calculation and coordination across multiple injection series.
Immunotherapy Injection Visit Management
Systematic billing for allergy injection visits (95115 single injection, 95117 two or more) with dose progression tracking, reaction documentation, and correct E&M billing when a separate physician service is documented.
Biologic & Specialty Drug Prior Authorization
End-to-end prior authorization management for dupilumab, omalizumab (Xolair), mepolizumab, and other biologics used in allergy and asthma, with step-therapy documentation and re-authorization tracking.
Allergy & Immunology Billing Challenges That Reduce Immunotherapy Revenue
Allergy billing is governed by precise test-count rules and dose-tracking requirements that most general billing teams cannot manage accurately. These are the revenue gaps our team closes.
- Accurately coding for allergy testing, distinguishing between percutaneous (prick) and intradermal tests.
- Billing for the preparation of allergy extracts (antigens) for immunotherapy.
- Managing the complex billing for immunotherapy injections (shot visits) over a long period.
- Ensuring proper coding for the number of vials and doses administered.
- Navigating payer policies for covered vs. non-covered tests and treatment.
- Certified allergy coders with specialized knowledge of CPT and HCPCS coding for allergy services.
- Precise coding for all allergy testing, including percutaneous (95004), intradermal (95017, 95018), and patch tests.
- Expertise in billing for the preparation of antigen vials (95144-95170) based on the number of doses.
- Meticulous management of immunotherapy injection billing, tracking patient visits and doses.
- Proactive verification of insurance benefits for allergy testing and treatment.
- Detailed support for coding for pulmonary function tests and other related diagnostics.
How We Maximize Allergy & Immunotherapy Revenue for Your Practice
Our allergy billing workflow manages the complete lifecycle of allergy care — from initial testing to antigen preparation, injection visit billing, and biologic therapy prior authorizations.
Allergy Skin Test Coding & Count Verification
Precise test-count billing for percutaneous testing (95004), intradermal immediate-type testing (95017-95018), and patch testing (95044) with payer-specific panel size limits and correct count documentation.
Antigen Preparation & Extract Vial Billing
Dose-based antigen preparation billing (95144-95170) distinguishing single-antigen (95145) from multi-antigen extracts (95165) with correct unit calculation for the total doses per vial set and payer-specific coverage rules.
Immunotherapy Injection Visit Billing
Accurate billing for allergy injection visits (95115 for one injection, 95117 for two or more) with dose-progression tracking across the build-up and maintenance phases and correct E&M billing when warranted.
Biologic Allergy Therapy Prior Authorization
Complete prior authorization management for Xolair (omalizumab J2357), Dupixent, Nucala, Fasenra, and other biologics with IgE level and eosinophil count documentation and ongoing re-authorization support.
Food & Drug Challenge Billing
Specialized coding for supervised oral food challenges (95078, 99499 with modifier when needed), drug challenge procedures, and patch test interpretation visits with correct medical necessity documentation.
Allergy & Immunology CPT Coding Services That Prevent Claim Denials
From percutaneous test count rules to antigen preparation dose calculations, these are the precision coding areas that determine accurate reimbursement for allergy practices.
- Allergy testing coding based on the number of tests and method (percutaneous vs. intradermal).
- Antigen preparation coding based on the number of doses and whether it's a single or multiple antigens.
- Immunotherapy injection coding based on the number of injections per visit.
- Distinguishing between professional and technical components for testing interpretation.
Incorrect coding for the number of allergy tests performed.
Billing for testing or treatment that is not a covered benefit.
Unbundling of antigen preparation codes.
Incorrect coding for immunotherapy injection visits (e.g., using an E&M code instead of injection code).
Lack of medical necessity for testing based on patient history.
Allergy & Immunology CPT & ICD-10 Codes for Accurate Reimbursement
Our allergy coders are trained across the complete allergy testing, immunotherapy, and biologic therapy CPT and HCPCS code sets used in modern allergy and immunology practice.
CPT
95004 (Percutaneous Tests), 95017 (Intradermal Tests), 95165 (Antigen Preparation), 95115 (Immunotherapy Injection), 99213 (Office Visit)
ICD-10
J30.9 (Allergic Rhinitis), L50.0 (Urticaria), J45.909 (Asthma), T78.40XA (Allergy, Unspecified), Z88.9 (Allergy Status)
Frequently Asked Questions
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Revenue cycle services for this specialty
Connect specialty-specific billing needs with the core MI MedCare services that keep claims accurate, compliant, and moving.
Medical Billing
End-to-end medical billing services that improve claim acceptance and accelerate reimbursements.
Revenue Cycle Management
Complete RCM solutions covering patient intake, billing, payments, and financial reporting.
Medical Coding
Certified coders ensure accurate ICD-10, CPT, and HCPCS coding for compliant claims.
Credentialing
Provider credentialing and payer enrollment to get your practice contracted faster.
Eligibility Verification
Insurance eligibility and benefits verification before services are delivered.
Denial Management
Identify denial causes, correct errors, and recover lost revenue efficiently.