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Practice Coding Overview

The AAAAI offers coding resources for the practicing allergist / immunologist. Check back often to review recently asked coding questions. For specific coding questions or concerns, contact coding@aaaai.org.

AAAAI does not assume and it hereby disclaims any and all liability to any person or entity for any claims, damages, liability or other loss (including, without limitation, any liability for injury or other damage resulting from any use of or reliance on this service or from the posting or transmission of any information, content or material on this service by AAAAI, or any third party). By using this service the user releases AAAAI and its directors, officers, members, or agents from and against any and all such liability. The user assumes all risks of using the materials included in this service.


August 2024
Did you miss the 2024 Practice Management Workshop? Recordings are now available and feature three coding sessions:

Introduction to Coding and Billing – Kristin Vaughn, CPC
Provides the basics in medical coding for young allergists or practice managers with minimal exposure to allergy/immunology coding principles.

Coding Updates for Allergy Practice – Kristin Vaughn, CPC
An overview of the most recent coding updates for allergy practice.

Cracking the Code: Solving Your Coding Conundrums – Anna Davidson, CPC, CPMA
Case-based session walking through some challenging real-world coding scenarios from allergy practice.

2024 Coding Updates Webinar
In this 60-minute webinar, AAAAI Coding Consultant Kristin Vaughn, CPC, QMGC, QMC, CPMA, ICDCT-CM, at AskMueller LLC and Emily Graham, RHIA, CCS-P, VP of Regulatory Affairs at Hart Health Strategies, discuss:
• 2024 coding guidelines
• Commonly used codes and documentation needed for billing
• USP 797 documentation requirements
• The most current telehealth flexibilities
• Medicare physician reimbursement

Review the slides from the AskMueller, LLC. and Allergy Testing and Immunotherapy Payer Policies

Review the slides from the Hart Health Strategies, Inc.

Review 2023 CMS values for commonly used allergy/immunology codes

2022 version of Coding and Billing Basics now available

January 1, 2022
Review new allergy / immunology codes.

Modifier 93 – Synchronous Telemedicine Service Rendered Via Telephone or Other Real-Time Interactive Audio-Only Telecommunications System:
Synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located away at a distant site from the physician or other qualified health care professional. The totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that is sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction.

January 14, 2021
On January 14, 2021, the Centers for Medicare and Medicaid Services (CMS) released a fact sheet, Physician Fee Schedule (PFS) Payment for Office/Outpatient Evaluation and Management (E/M) Visits that provides additional information and guidance on recent changes to E/M services as a result of the CY 2021 PFS final rule.

Complex Care Add-on Code
In the CY 2021 PFS, CMS finalized an “add-on” code for visit complexity, HCPCS G2211. However, payment for the code was delayed under the Consolidated Appropriations Act, 2021, until January 1, 2024 or later. According to the CMS notice, “Practitioners may report this code for qualifying visits furnished on or after January 1, 2021, although we assigned a PFS payment status indicator of ‘B’ (Bundled) until 2024.”

Implementation of this add-on codes is anticipated to increase reimbursement for Allergy/Immunology professionals and other cognitive specialties. Therefore, we encourage AAAAI members to report this code with their E/M services (i.e., CPT 99202 – 99215). This will help CMS understand how the code would be used, as well as revise its budget neutrality estimates when the code is able to be reimbursed in CY 2024.  

Medical Review of E/M
CMS also discusses medical review when practitioners use time to select visit level, stating that, “Our reviewers will use the medical record documentation to objectively determine the medical necessity of the visit and accuracy of the documentation of the time spent (whether documented via a start/stop time or documentation of total time) if time is relied upon to support the E/M visit.”

It is necessary to appropriately document time in the medical record when it is used for E/M code selection. This may be supported through available audit tools as part of an electronic health record (EHR).

December 17, 2020
In anticipation of revised 2021 Evaluation/Management (E/M) codes, the AAAAI offers these current and anticipated resources:

Effective January 1, 2021, the Current Procedural Terms (CPT®) codes 99202-99215 will no longer require history components and/or exam components to determine the level of code to be selected. Changing these documentation requirements will reduce note “bloat” without impeding good patient care.  The provider will need to document only relevant history and perform only relevant exam(s), necessary for appropriate patient care, as determined by the provider reporting the service.

In 2021, CPT code 99202-99215 selection will be based on either medical decision-making or time. The provider reporting the service will have the option to choose either time or medical decision-making to support the reported E/M level.  Time will now be total time spent on the date of the encounter involving the provider’s time whether it is face to face time or non-face to face time involved in the patient’s care.

These changes reflect the goals of the 2017 Patients Over Paperwork initiative as advanced by the Centers for Medicare and Medicaid Services (CMS) to:

  • Put patients first;  
  • Establish internal processes to evaluate and streamline regulations;
  • Enhance efficiency; and,
  • Improve the patient experience

With goals to:

  • Bring satisfaction to users (clinicians, institutional provide  health plans etc.)
  • Reduce the amount and hours spent on CMS-mandated compliance
  • Increase the number of tasks CMS customers can do digitally

In 2020, the American Medical Association followed the lead of CMS and changed the requirements for New and Established patient evaluation and management codes [99202-99215]. The real benefit and driving force behind Patients Over Paperwork is optimizing workflows so that clinicians can focus on patients, not paperwork.

Helpful Links

New 2024 Codes »

2023 Allergy/Immunology CPT Superbill Template »

New 2023 Codes »

Review 2022 CMS values for commonly used allergy/immunology codes here » Coding

Use of Telemedicine during the COVID-19 Pandemic »

Frequently Asked Coding Questions » Coding

New 2022 Codes »

New 2021 Codes »

New 2020 Codes »

Preview of 2021 Revised E/M and Other Coding Guidelines »

Medicare Payment, E/M Coding and RAC Updates January 2020 » Coding

RAC Webinar Slides January 2020 (PDF) » Coding

RAC Webinar Questions and Anwsers January 2020 (PDF) » Coding

RAC Webinar Recording January 2020 » Coding

E/M and Procedural Coding Case Studies »

ICD-10 New Codes for 2020 » Coding

Advance Beneficiary Notice of Non-coverage (ABN) »

Advance Beneficiary Notice of Non-coverage (ABN) » Coding

Clarifying MUEs for CPT Code 95165 » Coding

Coding for Bee Immunotherapy »

Coding for Chronic Care Management » Coding

Coding for Penicillin Testing » Coding

Chronic Care Management Services » Coding

CMS and Medically Unlikely Edits »

Helpful Websites for Correct Coding » Coding

ICD-10 Coding »

Practice Management Resource Guide: Chapter 6: Coding and Billing Basics » Coding

Summary of AAAAI Payer Correspondence and Responses » Coding


Items which appear next to a Practice Finances symbol are for AAAAI members only.

Check back often for new information and to review recently asked coding questions. For specific coding questions or concerns, contact coding@aaaai.org.