Allergy Services with Evaluation and Management Services
- Los Angeles
- San Diego
- San Joaquin
Evaluation and management (E&M) services for established member office visits (99211-99215) are considered to be included with allergy testing (95004-95075) and allergy immunotherapy (95115-95199) unless a significant, separately identifiable service was performed. In this case, bill the E&M code with modifier -25. Documentation is not required with the claim but the medical record must support the use of modifier -25.
Health Net does not require documentation at the time of claim submission; however, in the event the claim is audited, documentation may be required.
- American Medical Association (AMA) CPT Book
- CMS National Policy