Allergy Immunotherapy (Allergy Shots)
Please read the following Frequently Asked Questions
What is subcutaneous immunotherapy?
It involves injections of the things to which you are allergic. For example, if your skin test showed that you are allergic to trees; small amounts of tree pollen extract will be used in your allergy vaccine.
Will my insurance cover my allergy injections?
Insurance coverage varies. Some insurance companies require that you pay a co-payment for an allergy injection. Please check with your insurance company regarding coverage.
Calling your insurance plan’s member services department is the best way to find out your out of pocket expenses for allergy services. Record the date, the phone number called, and the first and last name of the representative. Request a supervisor and record their name as well if your benefits are still unclear. If your insurance misquotes you, these details may help you challenge a charge billed to you.
There are two types of charges billed for immunotherapy: a serum or venom charge and an injection charge. Your serum supply is the first charge submitted to your insurance. The CPT code for allergy serum is 95165. The injection you receive on a weekly basis (in the beginning) is the second charge billed to your insurance. This code is 95117. It is the only code billed for your injection visit. We do not bill an office visit code with allergy injections unless you are seen by the doctor that day. If you have a reaction to your injection or you have a regular office visit for that day, other charges will apply.
The following questions will be helpful in determining the charges you may incur when beginning immunotherapy. Will I have a co-pay, deductible, or coinsurance for my allergy serum? (The CPT code billed is 95165). Will I have a co-pay, deductible, or coinsurance for my allergy injections? (The CPT code billed is 95117).
How do shots work?
By gradually increasing the dose over time, your body will build a resistance to the allergen. You will then have fewer symptoms when exposed naturally. If you are getting shots for your tree allergy you should notice less sneezing, itchy eyes, etc. in the spring when tree pollen is in the air. Allergy shots help only with those allergens included in your injections, and may prevent the development of new allergies.
How soon should the shots start to work?
Because the injections are started at a very low dose, they generally do not start working for about three to six months. Sometimes it takes a year or two to notice significant improvement.
How often do I get the injections?
Allergy shots are given weekly in the buildup period, which is generally about 31 weeks. Once a high dose called maintenance is reached, the shots are gradually given less often. They are usually continued every two-four weeks. During a pollen season more frequent injections can be helpful. Injections also may be given twice a week, with a separation of at least 3 days. This will result in a reduction of the buildup period.
When can I get the shots?
Included is an injection schedule with our office walk-in hours. If your primary care physician’s office is more convenient for you, we will provide complete instructions so you may take your allergy vaccine there. A physician must be present at that location while you receive your injection. The precautions listed on this sheet are even more important to follow if your injections are given at another doctor’s office. If you have a fever or are feeling ill you may not be given an injection.
For how long do I need to take shots?
Allergy injections are usually given for three to five years, though some benefit from a longer course of treatment. If the injections do not start to help within two years they may be be stopped or changed. If you are just beginning, you must have a 6 month follow-up and then a yearly visit to review progress with the doctor which is required while on injections.
What happens if I miss a shot?
Missing an occasional shot or being late does not affect the long-term benefit. The doctor or nurse will adjust the dosage to a safe level. If you miss shots for many weeks you, may not build up to a high enough dose for them to be helpful. Consult with our clinical staff if you will need to miss several visits.
Are allergy injections safe?
Allergy injections have been used for more that 100 years with no long-term side effects. They can cause an allergic reaction beginning shortly after the shot is given.
What are the side effects of allergy injections?
The most common side effect of an allergy injection is a small amount of redness, itching or swelling at the injection site. Sometimes a person will notice some mild allergy symptoms or flu-like symptoms within 24 hours after a shot. Tell the nurse at your next injection whenever you notice symptoms that may be related to the allergy injection.
If I receive an immunization such as, Influenza, how much time should pass before receiving allergy shots?
Please wait until at least the third day after receiving any immunization before having allergy shots.
Can I receive shots if I am under-the-weather?
If you have a fever and/or wheezing or generally are not feeling well enough to go to work/school please wait until you feel better before having an allergy shot.
More serious allergic reactions, called systemic reactions are rare. Symptoms include itching, hives, throat tightness, wheezing, and shortness of breath, dizziness or light-headedness. Life-threatening reactions are extremely rare but a few deaths have occurred after allergy shots. For this reason you should always stay in the doctor’s office for 30 minutes after your injections no matter how long you have been getting them. If you have an epinephrine pen, you should always be carrying it.
How to prevent serious reactions – Take these precautions!
- Wait the 30 minutes in the doctor’s office after injections.
- Inform the nurse before your next shot of any swelling at the injection site that appeared larger than the size of a quarter, or any other symptoms that may be related to your allergy injection.
- Always call us immediately or go directly to the emergency room if you notice any breathing difficulty, generalized itching or rash, or feel especially ill soon after your shot.
- Let us know as soon as possible if you become pregnant or plan on becoming pregnant.
- Inform us of any new medications that you are taking. Certain medications, such as beta-blockers (taken for high blood pressure, glaucoma, migraine headaches and other diseases) or monoamine oxidase inhibitors may be a contraindication and will be handled on a case by case basis.
- If you have a fever or are feeling ill, you may not be given a shot. You will not be given an injection if you have hives or wheezing. Call ahead or inform clinical staff before your injection.
- Avoid strenuous exercise at least 3 hours after your injection.
- Always let us know if your allergies and/or asthma have been bothersome before your injection.
Do I still take allergy medication?
The goal of immunotherapy is to control your allergy symptoms without medications. You may still need to take some medications to control your allergy symptoms. Using a medication will not decrease the benefits of allergy shots; in fact, taking a long-acting antihistamine the morning of allergy shot days may help the process.
Do I still continue to see the allergy doctor?
Yes. A yearly visit is needed to monitor your allergies and general health, update progress, reassess medications and reissue any prescriptions. A more frequent visit may be required for asthmatic patients. If you receive injections at another office, you should bring your injection schedule with you as well as any empty serum vials if you are renewing a serum prescription at the same time.
How long will my current vaccine last?
Your vaccine expires in one year. Your new vaccine will be a little stronger (vaccine loses some of its potency over time) so the dosage will be cut back slightly and you will have to build back up. You can do this by coming in twice a week, weekly or every two weeks. It usually takes 3 doses to be back up to maintenance.
WE WANT ALLERGY INJECTIONS TO IMPROVE THE QUALITY OF YOUR LIFE. IF YOU HAVE OTHER QUESTIONS OR CONCERNS, PLEASE FEEL FREE TO ASK.