These services may or may not be covered by all CoOportunity Health plans. Please see your plan documents for your own coverage information. If there is a difference between this general information and your plan documents, your plan will be used to determine your coverage.
Administrative process
Prior authorization is required for sublingual immunotherapy tablets through CoOportunity Health pharmacy administration.
Refer to the CoOportunity Health Drug List (formulary) website for details.
Coverage
Sublingual tablets to treat allergies require prior authorization through CoOportunity Health pharmacy administration. Refer to the CoOportunity Health Drug List (formulary) website for details.
Indications that are covered
Refer to the CoOportunity Health Drug List (formulary) website for Drug List Changes and prior authorization criteria for sublingual immunotherapy tablets.
Indications that are not covered
Single or compounded allergy drops for allergy treatment are considered investigational and not covered.
Definitions
Sublingual drops are allergen extracts held under the tongue. These are not approved by the FDA.
Sublingual immunotherapy (SLIT) refers to allergy testing and treatment performed under the tongue (sublingual).
Sublingual tablets are FDA-approved for the treatment of pollen-induced allergic rhinitis.
Codes
If available, codes are listed below for informational purposes only, and do not guarantee member coverage or provider reimbursement. The list may not be all-inclusive.
The services associated with these codes require prior authorization:
91599 – Unlisted allergy/clinical immunologic service or procedure
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This information is for most, but not all, CoOportunity Health plans. Please read your plan documents to see if your plan has limits or will not cover some items. If there is a difference between this general information and your plan documents, your plan documents will be used to determine your coverage.
CoOportunity Health has contracted with HealthPartners Administrators, Inc. to provide claims processing, medical management and certain other administrative services.