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Supply code

Kathy Posted Thu 28th of June, 2012 12:40:47 PM

Do you know what the supply code is for Benzylpenicilloyl Polylysine (PRE-PEN) 0.25 mL Intradermal Solution? Our allergist used this for allergy testing purposes and reported supply code J2540 but I am not sure that is correct. Thank you!

SuperCoder Answered Thu 28th of June, 2012 16:26:47 PM

Hi, Kathy,

The RBRVS Data Manager practice expense breakdown indicates that the venom antigen is included in the payment for J5015, Intracutaneous (intradermal) tests, sequential and incremental, with drugs, biologicals, or venoms, immediate type reaction, including test interpretation and report by a physician, specify number of tests. According to the AMA Direct Practice Expense of J5015, the code includes the following Medical Supply Direct Inputs:
Supply Code Description
SA048 pack, minimum multi-specialty visit 0.07 $ 0.08001
SG050 gauze, non-sterile 2in x 2in 0.14 $ 0.00182
SG021 bandage, strip 0.75in x 3in (Bandaid) 0.5 $ 0.0215
SH072 triamcinolone acetonide 0.1% cream 0.02 $ 0.00104
SH009 antigen, venom 0.3 $ 3.21
SH004 albumin saline 1 $ 0.08
SJ053 swab-pad, alcohol 0.14 $ 0.00182
SL027 color coded cap and vial (for antigen) 1 $ 0.564
SC052 syringe 1ml 0.07 $ 0.0098
SC029 needle, 18-27g 4 $ 0.356
SB006 drape, non-sterile, sheet 40in x 60in 0.1 $ 0.0222
SL085 label for microscope slides 1 $ 0.026

The Pre-Pen manufacturer's reimbursement guide (http://www.alk-abello.com/US/education/web-based/Documents/PRE-PEN%20Reimbursement.pdf) also suggests no separate supply coding. "CPT codes for PRE-PEN are same as venom testing
– Skin Prick Tests: 95010 x 4 units
– Intradermal Tests: 95015 x 5 units
– Oral challenge: 95075 x 1 procedure (optional."

Best,
Jen
--
Jen Godreau, CPC, CPMA, CPEDC

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