Kimberly Posted Wed 10th of September, 2014 16:41:52 PM
When should you bill 95027 instead of 95024? I need a complete understanding of the difference for an Anthem problem
SuperCoder Answered Thu 11th of September, 2014 02:20:55 AM
Following is the difference between 95024 and 95027 to use for reporting skin testing.
Your main clue is whether the tests are sequential. Pulmonologists may administer 95024 (Intracutaneous [intradermal] tests with allergenic extracts, immediate type reaction, including test interpretation and report by a physician, specify number of tests) using allergenic extracts. Report 95024 according to the number of tests the physician performed.
Intradermal dilutional testing (IDT) refers to 95027 (Intracutaneous [intradermal] tests, sequential and incremental, with allergenic extracts for airborne allergens, immediate type reaction, including test interpretation and report by a physician, specify number of tests).
Example: Consider a patient who requires three tests of increasing strength to determine his end point for 14 allergens, including dog dander, pine, hickory, and Bermuda grass. You should report 95027 x 42 units (14 allergens multiplied by 3 tests). Each unit represents one stick or dilutional test per antigen.
Hope this will help !!
Source: Pulmonology coding alert.