Key takeaways Allergy testing and immunotherapy use separate, non-interchangeable CPT code sets. Billing the wrong code combination triggers denials regardless of medical necessity. Immunotherapy dose miscounting is one of the most common sources of underpayment. Medicare does not cover complete-service immunotherapy codes; component billing is required. Modifier 25 has specific, narrow rules for same-day E/M […]
Navigating the Wild West of Allergy and Immunology Billing
Key takeaways Allergy and immunology billing involves complex coding, payer variability, and documentation standards that change frequently. Practices often experience denials or delayed payments even when care is delivered correctly and consistently. Payer rules around allergy testing and immunotherapy are a common source of revenue leakage. Working with a billing partner that understands allergy and […]