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Family Practice Coding Alert

Reader Questions:

Skip Injection Code With TB Test

Question: What is the correct injection code to file when a nurse injects PPD for a TB skin test? We have been using 90782, but a lot of insurance companies are denying the code.

Missouri Subscriber Answer: The insurers are correctly rejecting the injection code (90782, Therapeutic, prophylactic or diagnostic injection [specify material injected]; subcutaneous or intramuscular). The injection for the tuberculosis (TB) skin test is not a therapeutic, prophylactic or diagnostic injection as 90782 describes.
Reality: You shouldn't report any injection code with 86580 (Skin test; tuberculosis, intradermal). The TB skin test includes the injection administration. The nurse has to inject the purified protein derivative (PPD) concentration to assess the disease's presence.
Bottom line: For a TB test, you would instead simply report 86580 and V74.1 (Special screening examination for bacterial and spirochetal diseases; pulmonary tuberculosis).

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