Reminder: CPT Codes 95115 and 95117 - One (1) unit only, when billing for one or more injections given on the same day
Blue Cross and Blue Shield of North Carolina (BCBSNC) wants to remind professional providers about the billing guidelines for antigen injections when using CPT Codes 95115 and 95117.
Providers filing claims for the professional services of an injection, which do not include the supply of the antigen serum, should report services using codes 95115 or 95117. Both of these codes are used to report the injection only, and exclude the provision or preparation of the extract. Code 95115 may be used for a single injection; 95117 covers two or more injections. The correct quantity (number of units) is always one (1) for both codes. Codes 95115 and 95117 should not be billed on the same date of service by the same provider. Report either 95115 or 95117 during a single patient encounter. If one injection is given, report 95115 (only). If two or more injections are given, report 95117 (only).
CPT 95115 - Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection
- Only file when giving a single injection
- Represents one injection and should be filed with one unit
- Cannot be reported with 95117 on the same date of service
CPT 95117 - Professional services for allergen immunotherapy not including provision of allergenic extracts; two or more injections
- Only file when providing multiple injections
- Represents multiple injections and should not be billed with multiple units of service. Always bill with one (1) unit
- Cannot be filed with 95115 on the same date of service
- 95117 should be reported just once per patient per date of service