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Allergy Testing Limitations

Cheryl Posted Thu 01st of July, 2010 14:22:58 PM

Does anyone know the Limitations on Allergy Testing, CPT Code 95004 and 95024.

I need to know how many times they can have this performed and paid for by Medicare. Example. once a year... every two years.... ?

Thanks

Candice

SuperCoder Answered Fri 02nd of July, 2010 05:58:44 AM

As per Trilblazer statement
(CPT code 95004)Medicare would not expect that more than 75 percutaneous tests per year are medically necessary for the management of an individual patient. More than 75 tests per year may be allowed upon review when the clinical circumstances documented in the patient’s medical record substantiate the need for additional tests.
(CPT code 95024) Medicare would not expect that more than 20 intradermal or intracutaneous tests per year are medically necessary for the management of an individual patient. More than 20 tests per year may be allowed upon review when the clinical circumstances documented in the patient’s medical record substantiate the need for additional tests.

Cheryl Posted Tue 06th of July, 2010 16:03:41 PM

Alex. Thank you for your response. I appreciate it.

Candice Ruffing, CPC CENTC
South Coast Ear, Nose and Throat
772-323-2174

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