Allergy Injections and E/M on the Same Date

Question:

We routinely bill allergy an E/M service when the patient comes in for allergy shots.  Is that acceptable?  Sometimes we bill 99211 if the nurse gives the injection and sometimes if the PA gives the injection 99212.

Answer:

E/M visits should not be reported with allergy injection services 95115 or 95117 unless the visit represents another separately identifiable service.  In that situation, report the E/M service with modifier 25 indicating that the patient’s condition required a significant, separately identifiable visit service above and beyond the allergen immunotherapy service provided. If the only service provided is the allergy injection do not report an E/M service. Good documentation is key when reporting an E/M and allergy injections on the same date.

*This response is based on the best information available as of 04/27/23.