SpecialtiesMedical specialties
How we see allergy & immunology billing.
Reviewed by the VisMed medical specialties billing team
Skin testing is billed per test, with payer limits on the number per session and per year. Immunotherapy is billed per dose prepared and per injection given, with rules about how many vials, how many antigens and how many months a preparation can cover. Every one of those counts is checked by the payer, and every one is a place where the practice bills too few or too many.
Biologics for asthma, urticaria and eosinophilic disease bring the infusion economics of rheumatology into the allergy clinic: authorization per indication, units, NDC, and allowed rates that may not cover acquisition. Food and drug challenges add time-based codes that need the hours documented.
VisMed reconciles testing and immunotherapy at the unit level against your records, runs a biologic desk for authorization and pricing, reconciles the injection schedule to charges every day, and gives you templates that capture time on challenges.
Where allergy & immunology practices lose money
The patterns we find in the aging and denial history before anything else changes.
Test counts unsupported or over limit
The number of tests billed must match the number performed and documented, and stay inside the payer’s per-session and annual limits. Mismatches are denials or recoupments.Immunotherapy preparation billed wrong
Preparation codes are billed per dose in the vial, with different codes for single-antigen and multi-antigen preparations and for venom. Errors here repeat every time a vial is mixed.Injections given but not billed
Nurse-administered injections during build-up and maintenance are frequent, small and easily missed at the desk.Biologics without authorization or below cost
Each biologic on each plan has criteria, step therapy and an allowed rate. Doses given outside them are losses.Challenges without documented time
Oral food and drug challenges are billed by time. Without the start and stop, they bill as a visit.
What we do differently for allergy & immunology
Specialty-matched coders and a denials specialist, working inside your own system.
We reconcile units to your records
Tests billed are matched to the testing record and the payer’s limits at charge entry; immunotherapy preparation is reconciled to the mixing log.We capture every injection
Every shot visit is a charge, reconciled daily against the injection schedule.Our biologic desk authorizes and prices
Authorization per patient per drug with expiry tracking, and reimbursement compared with acquisition per plan.We give you time-based templates
Challenge and desensitization notes record time so the correct code and units are supported.
What we bill
The procedure and code families your account team already works in.
Allergy & immunology billing, asked and answered.
What a physician-owner in this specialty asks on the first call.
Why are our skin-testing claims denied or cut?
Most often the number of tests billed exceeded a payer limit or did not match the documented count. VisMed checks both at charge entry and holds each plan’s limits in our rules.
How should immunotherapy preparation be billed?
Per dose prepared, with the code that matches the preparation type, reconciled to the mixing log and within the payer’s rules on how many doses a preparation can cover. VisMed reconciles monthly so the counts hold up.
Does VisMed handle biologic authorizations?
Yes, per indication and per plan, tracked to expiry. VisMed also compares each plan’s allowed rate with your acquisition cost so you know whether to buy-and-bill or route to specialty pharmacy.
Can VisMed make sure shot visits get billed?
VisMed reconciles the injection schedule against charges every day, so a nurse visit that was given but not charged is caught the same day.
How does VisMed bill venom immunotherapy?
Venom has its own preparation codes by the number of venoms in the vial, and payers scrutinize the count. VisMed bills from the mixing log, matches the venom count to the documented sensitivities, and applies each plan’s rules on how many doses a preparation may cover.
Also in medical specialties
Cardiology
Diagnostics, device checks and cath-lab professional fees.
Endocrinology
CGM, infusion and chronic-condition management codes.
Gastroenterology
Endoscopy, ASC splits and screening-vs-diagnostic rules.
Hepatology
Infusions, specialty drugs and prior authorization.
Nephrology
Dialysis MCP, monthly capitation and transplant follow-up.
Pulmonology
PFTs, sleep crossover and DME orders.
Rheumatology
Biologic infusions, J-codes and buy-and-bill.
Neurology
EEG/EMG, infusion and long-visit E/M.
Oncology
Chemotherapy administration, drugs and NDC reporting.
Hematology
Infusion and lab-linked visits.
Infectious disease
Inpatient rounds, long-term therapy and telehealth.
Dermatology
Lesion coding, pathology and cosmetic separation.
Pain management
Injections, ablations and strict authorization trails.
Psychiatry
Med-management with therapy add-ons, parity rules.
All specialties
The full list, in six groups
See where your allergy & immunology practice is losing money. Free.
Six months of aging and denials, read by people who bill your specialty every day — quantified as monthly leakage with a recovery estimate. Yours to keep.
or write directly hello@vis.med