Spring is in the air: CPT codes for allergies

April 10th, 2019 / By Kelly Long, CPC

Spring is in the air: the birds are chirping, the trees are starting to bud and the pollen count is increasing, bringing with it the dreaded springtime allergy season.

Allergy facts:

  • Allergies are the 6th leading cause of chronic illness in the U.S. with an annual cost of $18 billion. More than 50 million Americans suffer from allergies each year.
  • Allergic rhinitis, often called hay fever, is a common condition that causes symptoms such as sneezing, stuffy nose, runny nose, watery eyes and itching of the nose, eyes or the roof of the mouth.
  • Allergic rhinitis can be seasonal or perennial.
  • Symptoms of seasonal allergic rhinitis occur in spring, summer and early fall. They are usually caused by allergic sensitivity to pollens from trees, grasses or weeds, or to airborne mold spores.
  • Once diagnosed, allergic rhinitis treatment options are: avoidance, eliminating or decreasing your exposure to the irritants or allergens that trigger your symptoms, medication and immunotherapy (allergy shots).

To reduce your exposure to the things that trigger your allergies:

  • Stay indoors on dry, windy days. The best time to go outside is after a good rain, which helps clear that pesky pollen from the air.
  • Hand off lawn mowing, weed pulling and other yard work chores that stir up allergens to those that do not suffer from allergies.
  • Remove clothes you’ve worn outside and shower to rinse pollen from your skin and hair.
  • Don’t hang laundry outside—pollen can stick to sheets and towels which you then inadvertently bring indoors.
  • Check the internet for pollen forecasts and current pollen levels or turn on your local news station for pollen forecasts which are often shown with the weather report.
  • If high pollen counts are forecasted, be proactive and start taking allergy medications before your symptoms begin.
  • Close doors and windows at night or any other time when pollen counts are high.
  • Avoid outdoor activity in the early morning when pollen counts are at their peak.

When it does come time to see your physician for those allergy symptoms that just won’t ease up, the testing codes are as follows:

  • 95004: Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction, including test interpretation and report, specify number of tests
  • 95017: Allergy testing, any combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal), sequential and incremental, with venoms, immediate type reaction, including test interpretation and report, specify number of tests
  • 95018: Allergy testing, any combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal), sequential and incremental, with drugs or biologicals, immediate type reaction, including test interpretation and report, specify number of tests
  • 95024: Intracutaneous (intradermal) tests with allergenic extracts, immediate type reaction, including test interpretation and report, specify number of tests
  • 95027: Intracutaneous (intradermal) tests, sequential and incremental, with allergenic extracts for airborne allergens, immediate type reaction, including test interpretation and report, specify number of tests
  • 95028: Intracutaneous (intradermal) tests with allergenic extracts, delayed type reaction, including reading, specify number of tests
  • 95044: Patch or application test(s) (specify number of tests)
  • 95052: Photo patch test(s) (specify number of tests)
  • 95056: Photo tests
  • 95060: Ophthalmic mucous membrane tests
  • 95065: Direct nasal mucous membrane test
  • 95199: Unlisted allergy/clinical immunologic service or procedure

There are various options to treat allergic rhinitis. Medications can be used to treat seasonal allergies, nasal symptoms and itchy and watery eyes. Allergy immunotherapy can be effective for those who cannot get relief from the standard prescribed medications and over the counter options. Immunotherapy treatment can provide long-term benefit for people with allergies.

The CPT codes for allergy immunotherapy are as follows:

  • 95115: Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection
  • 95117: Professional services for allergen immunotherapy not including provision of allergenic extracts; two or more injections
  • 95120: Professional services for allergen immunotherapy in prescribing physician’s office or institution, including provision of allergenic extract; single injection
  • 95125: Professional services for allergen immunotherapy in prescribing physician’s office or institution, including provision of allergenic extract; two or more injections
  • 95144: Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, single dose vial(s) (specify number of vials)
  • 95165: Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single or multiple antigens (specify number of doses)

I hope you all have a wonderful spring and while you are enjoying the beautiful weather, take care of those allergies before they take a hold of you.

Kelly Long is a clinical development analyst with 3M Health Information Systems.