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    v1.0.30
    OpenPayerBilling CodesAllergen Immunotherapy Services and ProceduresCPT cpt-95199-allergy-immunology-unlisted-procedure
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    CPT 95199: Unlisted Allergy/Immunology Procedure

    CPT code 95199 is used to report unlisted procedures in allergy and immunology when there is no specific CPT code for the service, typically covering diagnostic or therapeutic allergy testing or immunotherapy procedures; service type: allergy/immunology procedures; typical site of service: allergist or immunology clinic, outpatient facility, or physician office.

    For related coverage guidance, see recent payer policy updates: Allergy Testing, Including Selected Blood, Serum and Cellular Testing and Toxicity Testing Corporate Medical Policy, Allergy Testing and Injections, Allergy Testing.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 34-year-old patient with a history of severe multiple aeroallergen sensitivities presents to an allergy/immunology clinic for a service not described by an existing CPT code. The patient requires a specialized diagnostic or therapeutic procedure — for example, custom preparation and administration of an investigational allergen extract, complex component-resolved testing not covered by standard panels, or a novel desensitization protocol involving unique dosing schedules and monitoring. The clinical workflow begins with evaluation by an allergist (history, focused exam, review of prior test results), ordering the specialized procedure, obtaining informed consent, preparing individualized materials or protocols in the clinic or laboratory, performing the procedure (which may include monitored administration, serial challenge exposures, or specimen handling), and post-procedure observation with documentation of response and any adverse events. Billing uses 95199 to report the unlisted allergy/immunology procedure; documentation must clearly describe the procedure, time, resources used, and clinical rationale to support medical necessity and to enable payer review.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    95004Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction; first 20 testsCommonly performed for initial skin prick testing prior to or instead of an unlisted specialized diagnostic test.
    95024Intradermal tests, sequential and incremental, with allergenic extracts, single dilution; first testUsed when intradermal testing is required; may precede or complement unlisted procedures when standard codes apply to parts of the evaluation.
    95115Professional services for allergen immunotherapy not required to be reported by CPT (single injection)Related to administration of allergen immunotherapy; parts of a complex immunotherapy regimen might be billed with 95199 if not otherwise described.
    95070Patch or application testPerformed for contact allergens; may be used alongside unlisted procedures when specialized contact testing is customized.
    96372Therapeutic, prophylactic, or diagnostic injection (subcutaneous or intramuscular)Used for administration of medications associated with desensitization or challenge protocols that are part of a complex unlisted allergy procedure.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207RC0000X
    2084P0800X
    208D00000X
    207L00000X
    385H00000X
    125K00000X
    125J00000X
    261QM1000X

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    J30.0Vasomotor rhinitis
    J30.1Allergic rhinitis due to pollen
    J30.2Other seasonal allergic rhinitis
    J30.9Allergic rhinitis, unspecified
    J45.21Mild intermittent asthma with (acute) exacerbation
    J45.22Mild intermittent asthma with status asthmaticus
    J45.901Unspecified asthma with (acute) exacerbation
    J45.909Unspecified asthma, uncomplicated
    K52.9Noninfective gastroenteritis and colitis, unspecified
    L20.84Intrinsic (allergic) eczema

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: Allergy/Clinical Immunology1 / 3

    10 rows

    PolicyPayerEffective Date
    Allergy Testing, Including Selected Blood, Serum and Cellular Testing and Toxicity Testing Corporate Medical Policybcbsvermont2026-11-01
    Allergy Testing and InjectionsUnitedHealthcare2026-10-01
    Allergy TestingProvidence Health Plan2026-10-01
    Diagnosis of Idiopathic Environmental IntoleranceOscar Health2026-10-01
    Allergen Testingblue cross blue shield - louisiana2026-09-15
    Allergen TestingBlue Cross Blue Shield - New Mexico2026-09-04
    ALLERGY TESTING / IMMUNOTHERAPYpriority_health_medicare2026-09-01
    Hereditary Angioedema - EkterlyCigna2026-08-15
    Omalizumab products (Xolair, Omlyclo) coveragePremera Bluecross2026-08-01
    Omalizumab Products (Xolair, Omlyclo) coveragePremera Bluecross2026-08-01

    Related Codes

    CPT-95115-ALLERGEN-IMMUNOTHERAPY-SINGLE-INJECTION

    CPT 95115: Allergen Immunotherapy, Single Injection

    CPT-95117-ALLERGY-IMMUNOTHERAPY-MULTIPLE-INJECTIONS

    CPT 95117: Allergen Immunotherapy, Multiple Injections

    CPT-95120-ALLERGEN-IMMUNOTHERAPY-SINGLE-INJECTION

    CPT 95120: Allergen Immunotherapy, Single Subcutaneous Injection

    CPT-95125-ALLERGEN-IMMUNOTHERAPY-MULTIPLE-INJECTIONS-SESSION

    CPT 95125: Allergen Immunotherapy, Multiple Injections

    CPT-95130-STINGING-INSECT-VENOM-ADMINISTRATION-OFFICE

    CPT 95130: Stinging Insect Venom Immunotherapy, Single Insect

    CPT-95131-STINGING-INSECT-VENOM-ADMINISTRATION-TWO-INSECTS-OFFICE

    CPT 95131: Stinging Insect Venom, Two-Species Administration

    CPT-95132-VENOM-IMMUNOTHERAPY-STINGING-INSECT-THREE-SPECIES

    CPT 95132: Stinging Insect Venom Immunotherapy for Three Insects

    CPT-95133-STINGING-INSECT-VENOM-IMMUNOTHERAPY-OFFICE-ADMINISTRATION

    CPT 95133: Stinging Insect Venom Immunotherapy for Four Insects

    CPT-95134-VENOM-IMMUNOTHERAPY-FIVE-INSECT-VENOMS-OFFICE-ADMINISTRATION

    CPT 95134: Stinging Insect Venom Immunotherapy Administration

    CPT-95144-ALLERGEN-IMMUNOTHERAPY-ANTIGEN-PREPARATION-SINGLE-DOSE-VIALS

    CPT 95144: Allergen Immunotherapy Antigen Preparation, Single-Dose Vial

    Showing 1–10 of 18

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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