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Venom testing for allergy

Carmen Posted Fri 09th of December, 2011 21:30:36 PM

Our physician performed intracutaneous tests for 5 different venoms; 27 injections were given.

What is the proper way to code for this service?

SuperCoder Answered Mon 12th of December, 2011 04:46:59 AM

Allergy testing includes, as technical services, the performance, evaluation, and reading of tests. The physician work of taking a history, performing a physical exam, deciding on the allergy tests to be used, interpretation of results, counseling and prescribing treatment, should be reported using a visit or consultation code as appropriate.

For CPT 95004-95028, indicate one unit for each test performed, for example, if 18 percutaneous tests are done, report procedure code 95004 and indicate 18 units.

CPT 95027 should be reported with the number of intracutaneous injections administered.

Claims reporting percutaneous or intracutaneous tests should be processed for payment (on a per allergen basis) under procedure code 95027.

If intracutaneous (intradermal) sequential and incremental injections (CPT code 95015) and single injection (CPT 95024) tests are performed on the same date of service, both the sequential and incremental injection and single injection test codes may be reported if the tests are different allergens of different dilutions of the same allergen.
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The unit of service to report is the number of separate injections.
Do not report both a single injection test and a sequential and incremental injection test for the same dilution of an allergen. For example, if the single injection test for and antigen is positive and the provider proceeds to sequential and incremental injection tests, with three additional different dilutions of the same antigen, the provider may report one unit of service for the single injection test code and three units of service for the sequential and incremental test code.
To code it correctly details needed for the above info.
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General Info of number of tests coverage:
The number of tests required may vary widely from patient to patient, depending upon the patient's history. There is a limit of 50 percutaneous and up to 20 intracutaneous skin tests per day.
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The number of intracutaneous allergy tests eligible for reimbursement per year is 40 (CPT codes 95024 and 95028)

Carmen Posted Mon 12th of December, 2011 17:11:50 PM

Can you bill 95015 and 95149 together in the same encounter?

SuperCoder Answered Mon 12th of December, 2011 18:01:05 PM

Not yet witnessed both billed together.
The reason I am not sure of such a scenario is that the code 95149 is for for Professional services, 95149 is code for Professional services including preparation and provision of antigens. [These codes do not, however, include the administration of the allergen therapy.]
If truly both preparation with professional supervision of preparation is provided along with administration of injection in the same session(which I have not witnessed earlier), I think you can bill both, though I am not sure of it.

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