Allergy & Immunology Billing Services in Utah

Utah's allergy & immunology practices face unique billing challenges shaped by SelectHealth (Intermountain)'s commercial rules, Utah Medicaid requirements, and Noridian Medicare policies. Our AAPC-certified coders specialize in both UT payer rules and allergy & immunology coding complexity.

AAPC Certified
UT Payer Expert
Allergy & Immunology Specialists
2.49% Rate
8,000+UT Physicians
2.49%Starting Rate
3Medicaid MCOs
98%+Clean Claim Rate

Why Utah Allergy & Immunology Practices Need Specialized Billing

Utah's healthcare market includes 8,000+ physicians, and allergy & immunology practices here face a payer market dominated by SelectHealth (Intermountain) on the commercial side and Utah Medicaid on the public payer side. Medicare claims are processed through Noridian, which applies its own Local Coverage Determinations that directly affect allergy & immunology procedure coverage and medical necessity requirements. Generic billing teams without UT specific knowledge leave revenue on the table.

Allergy & Immunology billing itself is complex. Allergy and immunology billing revolves around allergy testing codes (95004 percutaneous, 95024 intracutaneous, 95044 patch testing), immunotherapy administration (95115-95117 for injections, 95120-95134 for professional services with provision of antigen), biologic medication J-codes for severe allergic conditions, and pulmonary function testing (94010-94070). Test count accuracy is critical — each allergy test is billed per individual allergen, and a typical testing session involves 40-80 individual tests. When you combine this coding complexity with Utah's specific payer rules, authorization requirements, and 3 Utah Medicaid managed care plans that each have their own billing rules, you need a team that understands both dimensions. Go Medical Billing provides that expertise at 2.49% of collections, serving allergy & immunology practices from Salt Lake City to St. George and across Utah.

Top CPT Codes for Allergy & Immunology in Utah

Our UT coders handle these allergy & immunology codes daily, applying Noridian Medicare rules and SelectHealth (Intermountain) commercial policies to each claim.

Code
Description
95004
Percutaneous Test
95115
Immunotherapy
J0881
Biologic
94010
Spirometry

Utah Payer Challenges for Allergy & Immunology

Every UT payer has specific rules for allergy & immunology claims. Here's how we navigate them.

SelectHealth (Intermountain) Allergy & Immunology Claims

SelectHealth (Intermountain) processes the largest share of Utah commercial allergy & immunology claims. We know their UT specific fee schedules, prior authorization requirements for allergy & immunology procedures, and their appeal timelines when claims are denied. Allergy skin testing bills per individual allergen tested. A 60-allergen panel = 60 units of 95004. Inaccurate test counts directly reduce revenue or create audit risk.

Utah Medicaid Allergy & Immunology Billing

Utah Medicaid routes allergy & immunology patients through 3 managed care plans: Healthy U, Molina, SelectHealth Community Care. Each MCO has its own allergy & immunology authorization and billing rules that we manage.

Medicare (Noridian) Allergy & Immunology Coverage

Noridian processes Medicare allergy & immunology claims in Utah with its own Local Coverage Determinations. We navigate Noridian's policies around immunotherapy administration coding to prevent medical necessity denials.

Denial Prevention for Utah Allergy & Immunology

Common allergy & immunology denials in Utah include allergy skin testing bills per individual allergen tested and choosing between 95115 (single injection), 95117 (2+ injections), and 95120-95134 (professional component with antigen provision) depends on who prepared the antigen. Our team catches these issues before submission and appeals aggressively with UT payer-specific documentation when denials occur.

Get Expert Allergy & Immunology Billing in Utah

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98%+ clean claim rate
2.49% starting rate
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What We Handle for Utah Allergy & Immunology Practices

Allergy skin testing billing (95004, 95024, 95044)
Immunotherapy injection administration coding (95115-95134)
Biologic medication J-code billing and authorization
Pulmonary function testing (94010-94070)
Serum preparation and antigen provision billing
Component testing and in-vitro allergy coding (86003-86005)
Food allergy and drug allergy testing
Prior authorization for biologics and advanced testing

Utah Allergy & Immunology Billing Cost Comparison

Hiring an in-house biller with allergy & immunology expertise in Utah costs $36K-$50K annually in salary alone. Add benefits, software, clearinghouse fees, and office space, and the true cost is even higher. At 2.49% of collections, Go Medical Billing provides an entire team of AAPC-certified allergy & immunology coders and UT payer specialists for a fraction of that cost.

$36K-$50K

In-House Biller Salary

+ benefits, software, space

2.49%

Go Medical Billing Rate

Full team, all services included

60-80%

Typical Cost Reduction

With better results

Frequently Asked Questions

All major UT payers: SelectHealth (Intermountain), Regence, UHC, Molina, Utah Medicaid (including Healthy U, Molina, SelectHealth Community Care), and Medicare through Noridian. If a payer accepts allergy & immunology patients in Utah, we submit and follow-up on claims with them.
The most frequent allergy & immunology denials we see from UT payers include allergy skin testing bills per individual allergen tested, choosing between 95115 (single injection), 95117 (2+ injections), and 95120-95134 (professional component with antigen provision) depends on who prepared the antigen, biologics like omalizumab (j2357), dupilumab (j0881), and mepolizumab (j2182) require prior authorization, weight-based dosing verification, and step-therapy documentation. Our team catches these before submission by applying both allergy & immunology coding expertise and UT payer-specific rules to every claim.
Utah Medicaid routes allergy & immunology patients through 3 managed care plans: Healthy U, Molina, SelectHealth Community Care. Each MCO has its own allergy & immunology authorization requirements, fee schedules, and billing rules. We credential and bill with all of them so your allergy & immunology practice gets paid correctly.
Most UT allergy & immunology practices are fully transitioned within two to three weeks. We connect to your EHR, learn your allergy & immunology workflows, and start submitting claims to SelectHealth (Intermountain), Utah Medicaid, Medicare, and all your UT payers with no downtime.

Fix Your Utah Allergy & Immunology Billing

Call 888-701-6090 for a free billing assessment specific to your UT allergy & immunology practice. We'll show you where revenue is leaking and how to fix it.