Health Insurance

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It is of utmost importance to know how your insurance covers allergy evaluations, imaging and blood tests.  It is generally covered, but oftentimes patients have not met their annual deductible and have to pay-out-pocket until it is met.  Sometimes there is a co-insurance split between the patient and the insurance company.  It you have concerns about insurance coverage, it is your responsibility to know your policy and how it affects you prior to your appointment so we can work within your needs.  This should be located in your explanation of benefits, or EOB.  You can also call your insurance to figure exact out-of-pocket costs for potential procedures before you arrive.  Everyone should know how their health insurance policy works - you never know when you are going to need it!

Here are some helpful CPT codes if discussing allergy coverage with your insurance:

Allergy prick test:  95004 x the number of tests placed.  The average number for a standard environmental skin test is around 50 tests.  It could be more or less than this, though.

Intradermal allergy test: 95024 x the number of tests placed.

Oral challenge: 95076 (first two hours); 95079 (each additional hour)

Rapid desensitization: 95180 x the number of hours.

Venom skin test: code 95017 x the number of tests placed.

Drug skin test: code 95018 x the number of tests placed.

Patch test: code 95044 x the number of tests placed.

Baseline spirometry: 94010

Flow volume loop: 94375

Pre and post-bronchodilator evaluation: 94060

Exhaled nitric oxide: 95012

Fiberoptic laryngoscopy: 31575

Fiberoptic nasal endoscopy: 31231

Fiberoptic nasopharyngoscopy: 95211

Allergy injection bills are even more complicated.  Click HERE for a handout trying to explain how they work with your insurance.

Click here for a list of insurers with which we participate.