Nursing Visit on the Same Day as Allergy Injections

Question:

Can you bill a nursing visit when a patient comes in for an allergy injection?

Answer:

The routine preinjection and post injection evaluations by the nurse or MA would be included in codes 95115-95117 and would not be eligible to report separately.

When documentation supports that a significant, separately identifiable evaluation and management (E/M) service was rendered, the appropriate E/M code for the service may be reported. All care directly related to the administration of the injection, i.e., the injection cannot be administered without the preinjection and post injection check by the nurse.

However, if the nurse/MA provided any care unrelated to the injection, then code 99211 may be separately reported with modifier 25. However, such instances would be rare, and documentation would need to support both the service and its medical necessity.

*This response is based on the best information available as of 11/03/22.