Allergy & Immunology Medical Billing Services
Allergy and immunology billing combines allergy testing panels with ongoing immunotherapy injection administration, each with its own coding and same-day billing rules. Flint RCM's allergy accounts are staffed by coders fluent in both.
Specialty-specific pitfalls we watch for.
- Allergy testing panel coding errors when multiple test types are performed in one visit
- Immunotherapy injection billing (single vs. multiple antigen) coded incorrectly
- Same-day allergy testing and treatment billed without modifier -25 support
- Antigen preparation billing (vial mixing) not itemized separately from injection administration
- Prior authorization for specialty biologics (e.g., for chronic urticaria or severe asthma) not renewed on schedule
- Testing panel coding reviewed against the exact number and type of tests performed
- Immunotherapy injection billing checked for single vs. multiple-antigen documentation
- Same-day testing and treatment modifier -25 support reviewed before submission
- Antigen preparation billed separately from administration where documentation supports it
What makes Allergy & Immunology coding different.
- CPT 95004–95071 (allergy testing) coded to the exact number and type of allergens tested
- CPT 95165/95115–95117 (antigen preparation and immunotherapy injection) billed separately per documented service
- Modifier -25 applied where same-day E/M and testing/treatment are both documented as medically necessary
What to confirm before the visit.
- Prior authorization confirmed and tracked for renewal for specialty biologic therapies
- Medical necessity documentation confirmed for repeat allergy testing within a payer's frequency window
Antigen preparation and injection billing disputes are a common allergy denial source — AR follow-up verifies documentation supports both services as separately billed.
Our workflow for allergy & immunology billing.
Documentation Review
Visit notes are reviewed to confirm testing type, antigen counts, and same-day services.
Coding & Modifier Check
Testing, antigen preparation, and injection codes are checked against documentation.
Authorization Tracking
Specialty biologic authorization renewals are tracked to avoid treatment gaps.
AR Follow-Up
Testing and antigen-billing denials are worked with the visit documentation.
What shapes allergy & immunology reimbursement.
Payers vary in how they define "single" vs. "multiple" antigen immunotherapy for billing purposes — documentation is reviewed against the specific payer's definition before coding.
Allergy & Immunology billing, answered.
Do you bill antigen preparation separately from injections?
Yes — where documentation supports it, antigen preparation and injection administration are billed as distinct services.
How do you handle same-day testing and treatment visits?
Modifier -25 is applied only where documentation supports both services as separately medically necessary.
Explore more specialty billing pages.
Get a free allergy & immunology billing audit.
We'll review your current claims, denials, and AR to show exactly where allergy & immunology revenue is being missed.