How To Use CPT Code 95120

CPT 95120 describes the professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified healthcare professional, including the provision of allergenic extract through a single injection. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 95120?

CPT 95120 can be used to describe the professional services provided by a healthcare professional for allergen immunotherapy. This involves the gradual administration of purified allergen extracts via injection to help patients develop tolerance to specific allergens and reduce allergic reactions. This code specifically applies to a single injection administered during a session.

2. Official Description

The official description of CPT code 95120 is: ‘Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified healthcare professional, including provision of allergenic extract; single injection.’

3. Procedure

1. The healthcare professional prepares the allergenic extract for the specific allergens the patient needs immunotherapy for.
2. The patient visits the office or institution of the prescribing physician or qualified healthcare professional.
3. The healthcare professional administers a single injection of the allergenic extract to the patient.
4. The patient may be monitored for a period of time after the injection to ensure there are no adverse reactions.
5. Additional injections may be scheduled as part of the overall allergen immunotherapy treatment plan.

4. Qualifying circumstances

CPT 95120 is applicable when a healthcare professional provides allergen immunotherapy services in their office or institution. The patient must be under the care of the prescribing physician or another qualified healthcare professional. The injection must involve the provision of allergenic extract for a specific allergen. This code is used for a single injection during a session.

5. When to use CPT code 95120

CPT code 95120 should be used when a healthcare professional administers a single injection of allergenic extract for allergen immunotherapy in their office or institution. It is important to note that this code is specifically for a single injection during a session. If the provider administers two or more injections, CPT code 95125 should be used instead.

6. Documentation requirements

To support a claim for CPT 95120, the healthcare professional must document the following information:

• The specific allergenic extract administered
• Date of the session and start time of the injection
• Any monitoring or observation performed after the injection
• Progress made by the patient and any additional sessions scheduled
• Signature of the healthcare professional providing the service

7. Billing guidelines

When billing for CPT 95120, ensure that the service is provided in the office or institution of the prescribing physician or qualified healthcare professional. Use this code for a single injection during a session. It is important to note that CPT code 95120 should not be reported with other codes for allergen immunotherapy services. If multiple injections are administered, CPT code 95125 should be used instead.

8. Historical information

CPT 95120 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A healthcare professional administering a single injection of allergenic extract for a patient with severe allergic reactions to bee venom.
2. A prescribing physician providing a single injection of allergenic extract for a patient with allergic rhinitis caused by specific environmental allergens.
3. A qualified healthcare professional administering a single injection of allergenic extract for a patient with food allergies.
4. A healthcare professional performing a single injection of allergenic extract for a patient with allergic asthma triggered by specific allergens.
5. A prescribing physician administering a single injection of allergenic extract for a patient with allergic reactions to dust mites.
6. A qualified healthcare professional providing a single injection of allergenic extract for a patient with pet allergies.
7. A healthcare professional administering a single injection of allergenic extract for a patient with seasonal allergies.
8. A prescribing physician providing a single injection of allergenic extract for a patient with allergic reactions to specific medications.
9. A qualified healthcare professional administering a single injection of allergenic extract for a patient with mold allergies.
10. A healthcare professional performing a single injection of allergenic extract for a patient with allergic reactions to specific tree pollens.