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ppd codes for injection and vaccine?

Margaret Posted Thu 21st of October, 2010 18:37:52 PM

I would like to know what the correct codes for billing a ppd test in the office for pts on certain medications. Do you use 86580 with diag V74.1 and what do you bill for the vaccine? Thank You Margaret

Simone Answered Thu 21st of October, 2010 21:48:57 PM

I have read the CPT assistant stating not to bill for any administrative vaccine injection codes with PPD 86580.

Gerri Answered Thu 28th of October, 2010 18:49:17 PM

I agree, the 86580 includes the injection of the PPD into the skin and reading it within 72 hours.

Carolyn Answered Mon 01st of November, 2010 17:10:14 PM

No J code? for the price of the PPd

Gerri Answered Mon 01st of November, 2010 20:40:56 PM

It's included in the test and I don't believe there is a J code for the Mantoux.

SuperCoder Answered Mon 01st of November, 2010 21:22:06 PM

You are using the correct diagnosis code: V74.1(Special screening examination for bacterial and spirochetal diseases; pulmonary tuberculosis). Since the test an inoculation screening test , which detects antibodies and the presence of the disease, rather than a vaccination, the test includes administering the skin test and you should not code separately for the administration. The Resource Based Relative Value System does not include costs for a reading. Many patients who do not show a response to the teat may never return for a reading so this nurse administration cost is not included in the RVUs for 86580. If the patient does return for a reading, the test may be positive. In these cases, you may code 99211 for the nurse reading.
Jen Godreau, CPC, CPMA, CPEDC
Content Director,

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