Allergy and Immunology Medical Billing Services
Med Bridge handles allergy and immunology billing for allergists, immunologists, and allergy testing clinics accurate CPT/ICD-10 coding, allergy testing and immunotherapy billing, and denial recovery. Get a free billing analysis.
Allergy and immunology billing comes with its own set of challenges. Allergy testing codes depend on how many tests were performed and which method was used. Immunotherapy vials require careful J-code or pharmacy billing depending on the payer. Allergy shots also follow schedules that must be tracked, billed, and documented correctly. MedBridge manages the full allergy and immunology revenue cycle from eligibility checks through denial appeals, helping practices get paid for the care they provide.
15+ years in medical billing
140+ allergy and immunology providers served
HIPAA Compliant
Allergy and Immunology Billing & Coding Services
Med Bridge LLC
Allergy and Immunology Billing Service Specifications
Complete field-by-field overview for allergy and Immunology practices
| Service Type | Allergy and Immunology Medical Billing & Revenue Cycle Management |
|---|---|
| Practices Served | Independent allergists, immunologists, allergy and asthma clinics, allergy testing centers, pediatric allergy practices, immunology infusion centers, multi-specialty groups with allergy focus |
| Services Covered | Allergy skin testing, patch testing, intradermal testing, allergy immunotherapy, immunotherapy vial preparation, venom immunotherapy, food and drug challenges, spirometry, asthma management, immunology infusions (IVIG, biologics), patch testing |
| Coding Systems | CPT, ICD-10, HCPCS — including allergy testing codes (95004–95028), immunotherapy codes (95115–95117, 95144–95170), J-code drug billing, modifiers 25, 50, 59, and medical necessity documentation |
| Pricing | Percentage of collections no hidden fees, no setup charges |
| EHR/PMS Compatibilit | Epic, Cerner, ModMed, eClinicalWorks, athenahealth, NextGen, Allscripts |
| Compliance | HIPAA-compliant, SOC 2 Type II certified |
98%
Clean Claim Rate
23
Days Avg. A/R
3.8%
Denial Rate
48-hour
Claim Turnaround
What Is Allergy and Immunology Billing?
Allergy and immunology billing services cover the full revenue cycle for allergy practices, including eligibility verification, charge capture, CPT/ICD-10/HCPCS coding, claim submission, payment posting, and denial management.
Allergy and immunology billing also involves specialized testing and immunotherapy rules that require accurate coding and documentation.
Specialized Immunology & Allergy Billing Services
Allergy Testing Code Selection
Allergy skin testing (95004–95028) is billed according to the number of tests performed and the method used. Percutaneous, intradermal, and patch testing each have their own coding requirements.
Immunotherapy Billing Rules
Allergy immunotherapy (95115–95117) has specific rules for single versus multiple injections and whether vial preparation is billed separately (95144–95170). Requirements can vary depending on whether the practice mixes its own vials or uses a vendor.
Immunotherapy Vial and Extract Billing
Immunotherapy extracts may be billed as part of the injection code or separately, depending on payer requirements. Some payers may require pharmacy benefit billing instead of medical benefit billing for extracts.
IVIG and Immunology Infusion Billing
IVIG and biologics for immunodeficiency or autoimmune conditions may require prior authorization, J-code billing, and NDC mapping. These high-dollar claims require careful documentation and billing.
Allergy Shot Schedule Tracking
Allergy shots follow build-up and maintenance schedules. Each visit must be tracked, billed, and documented against the appropriate schedule.
Same-Day E/M and Testing
When an allergist performs testing during an office visit, modifier 25 may apply when the E/M service is separately identifiable and properly documented.
Food and Drug Challenge Billing
Food and drug challenges (95076–95079) require specific documentation, monitoring, and sometimes prior authorization. These claims require accurate coding and supporting documentation.
Payer Rules Change Every Year
Allergy and immunology coding updates annually, while payer requirements for testing, immunotherapy, and biologics can change over time.
Prior Authorization and Medical Necessity
Many allergy and immunology services, including biologics, immunotherapy, and specialized testing, may require prior authorization and detailed documentation supporting medical necessity.
Our Allergy and Immunology Revenue Cycle Management Process
Every claim goes through a six-step process designed to prevent denials before they happen.
Eligibility & Insurance Verification
We check coverage, co-pays, deductibles, and prior authorization requirements before the patient arrives. Testing and immunotherapy benefits are verified separately where required.
Charge Capture
Every service including office visits, skin testing, patch testing, immunotherapy injections, vial preparation, IVIG infusions, food challenges, and spirometry is converted into billable line items with the correct test counts and method codes.
Allergy and Immunology Coding
Certified coders apply CPT, ICD-10, and HCPCS codes with attention to allergy testing codes (95004–95028), test count and method, immunotherapy codes (95115–95117), vial preparation codes (95144–95170), and J-codes for IVIG.
Claim Scrubbing & Submission
Before submission, claims are reviewed for test count errors, immunotherapy coding mistakes, missing modifiers, NCCI edits, and medical necessity gaps. Clean claims are submitted within 24 hours.
Payment Posting
ERA/EOB posting is matched against expected reimbursement. Underpayments on testing and infusion claims are identified and appealed when appropriate.
Denial Management & Appeals
Denials are worked within 24–48 hours. Appeals include clinical documentation, coding rationale, and regulatory citations. Denial trends are tracked to identify recurring problems.
Allergy and Immunology Procedure & Specialty Coding Depth
Each allergy and immunology service family has its own coding and documentation requirements.
Allergy Skin Testing Billing
Percutaneous, intradermal, and patch testing each have specific codes and test count rules. Each test is reviewed for appropriate coding.
Immunotherapy Vial Preparation Billing
Vial preparation (95144–95170) may be billed differently depending on whether the practice mixes its own vials or uses a vendor. MedBridge manages the applicable coding and payer requirements.
Food and Drug Challenge Billing
Food and drug challenges (95076–95079) require specific documentation and monitoring. Claims are reviewed for the required supporting documentation.
Patch Testing Billing
Patch testing has specific codes and documentation requirements. Claims are reviewed against applicable payer criteria.
Immunotherapy Injection Billing
Allergy immunotherapy (95115–95117) has specific rules for single versus multiple injections. Injection claims are reviewed for accurate coding.
IVIG and Immunology Infusion Billing
IVIG and biologics may require prior authorization, J-code billing, and NDC mapping. Med Bridge manages the related authorization and billing workflow.
Spirometry and Asthma Management Billing
Spirometry and asthma management have their own codes and documentation requirements. Claims are reviewed to support proper reimbursement.
Pediatric Allergy Billing
Pediatric allergy testing and immunotherapy may involve age-specific coding and documentation requirements. MedBridge handles the related pediatric coding workflow.
Prior Authorization & Compliance
Prior authorization is especially important for IVIG and biologics, where individual claims can involve significant reimbursement.
Services That Commonly Require Prior Authorization
IVIG and immunology infusions
Biologics for asthma and autoimmune conditions
Food and drug challenges
Advanced testing with some payers
Immunotherapy with some payers
How We Handle Prior Authorization
Real-time eligibility and authorization tracking
Prior authorization requests submitted with required documentation
Re-authorization tracking for infusion therapy
Follow-up on pending authorizations
Compliance with the CMS Interoperability and Prior Authorization final rule for applicable turnaround requirements
Compliance Monitoring
HIPAA-compliant workflows and data security
Documentation audits for test count coding, immunotherapy coding, and modifier 25
Payer-specific rule tracking for testing, immunotherapy, and biologics
Annual coder training on CPT updates and allergy coding changes
Precision Medical Billing and Coding for Modern Healthcare Practices
Real Numbers From Allergy and Immunology Practices
These figures are presented in the supplied source as results from active allergy and immunology clients.
0
Days
Average Days in A/R
0
Hours
Claim Turnaround Time
0
%
Clean Claims Rate
16- 0
%
Average Collections Increase
0
%
Denial Rates
0
%
Prior Authorization Approval
0
%
Payment posting accuracy
0
%
First-pass acceptance rate
Why Med Bridge for Allergy and Immunology Billing Services?
Allergy and Immunology-Specific Certified Coders
Our coders are certified (CPC, CCS) and work in allergy and immunology. They understand allergy testing code selection, immunotherapy billing rules, vial preparation coding.
Faster Reimbursement
98.0% clean claim rate, 23-day average A/R, 48-hour claim turnaround These are the supplied performance metrics across 140+ allergy and immunology providers.
Data Security & Compliance
SOC 2 Type II certified and HIPAA compliant, with rigorous audit trails, regular reporting, secure data protection, access controls, and compliance monitoring.
Scales With Your Practice
Whether you are a solo allergist, multi-location group, or immunology infusion center, Med Bridge workflows can scale with your practice.
In-House vs. Outsourced Allergy and Immunology Billing
| Cost Category | In-House Billing | Med Bridge Outsourced |
|---|---|---|
| Biller salary + benefits | $50,000–$70,000 / year | — |
| Billing software + clearinghouse | $7,000–$15,000 / year | Included |
| Allergy Coding Training | $3,000–$6,000/year | Included |
| Denial write-offs | 6–11% of revenue | 3.8% denial rate |
| Total annual cost | $65,000–$100,000+ | Percentage of collections no hidden fees |
| Net annual savings | — | $30,000–$60,000+ |
Frequently Asked Questions
Allergy and immunology involves allergy testing code selection by test count and method, immunotherapy billing rules, vial preparation coding, IVIG and biologic J-code billing, and food challenge documentation requirements.
Yes. MedBridge works with independent allergists, immunologists, allergy and asthma clinics, allergy testing centers, pediatric allergy practices, and immunology infusion centers.
Monthly dashboards can include clean claim rate, A/R days, denial rate by payer, claim turnaround time, testing denial rate, and collections by service type. Ad-hoc reports can also be provided for specific payers or service categories.
Denials are worked within 24–48 hours. Appeals include clinical documentation, coding rationale, and regulatory citations. Denial reasons are tracked to identify recurring test count errors and immunotherapy coding mistakes.
MedBridge works with Epic, Cerner, ModMed, eClinicalWorks, athenahealth, NextGen, and Allscripts.
Pricing is structured as a percentage of collections. The supplied content states there are no setup fees, software fees, or hidden charges.
MedBridge tracks authorization requirements by payer, submits requests with supporting clinical documentation, and monitors re-authorization deadlines so infusion therapy does not get interrupted.
Most practices are fully onboarded within 30–45 days. The transition can include EHR access, payer enrollment, testing and immunotherapy setup, and allergy coding configuration.