Billing and Coding: Allergy Immunotherapy

Medicare pays for antigen/allergy immunotherapy under the physician fee schedule (effective 1/1/1995) but excludes sublingual, intracutaneous/subcutaneous provocative and neutralization testing and neutralization therapy for food allergies, and CPT codes 95120–95134 are not valid for Medicare. E&M codes may be billed only for a significant, separately identifiable service (use modifier 25) — obtaining informed consent is included in the immunotherapy service and must not be billed separately — and billing/coding must follow LCD L36408 and NCCI Chapter 11 edits.