# PPD Test Reading 99211



## heatherwinters (Mar 25, 2009)

I would like to know if anyone is billing 99211 for the office visit associated with the PPD reading in New York State and if Medicare is covering it for symptomatic patients.  i.e.  Patient presents with hempotysis, PPD performed, we bill 86580 with 786.3, two days later patient returns and sees nurse who reads ppd 99211 786.3 (results were negative).


See the following articles -


http://www.medscape.com/viewarticle/462014

Tuberculosis  Skin Tests

Q. PPD (tuberculosis) intradermal skin tests involve injecting  the PPD serum at one visit and examining the site two to three days later to see  if any swelling has developed. Do I need to submit the CPT code for the  intradermal skin test (86580) on the day the PPD is administered and then  interpret the PPD for "free" on a subsequent day as a bundled service; or can I  submit 99211 for the interpretation of the PPD by a nurse?

A. You can  submit 99211 if a patient requires subsequent evaluation of a test and no other  service is performed. Medicare will also pay for this limited service. Note that  if a nurse or other nonphysician provider who is unable to bill for this service  under his or her own Medicare provider number performs this service under the  physician's provider number, the "incident-to" requirements must be met. [For  more information on Medicare's incident-to requirements, see "The Ins and Outs  of 'Incident-To' Reimbursement," FPM, November/December 2001, page  23.]



http://www.aafp.org/fpm/20080100/coding.html
 Diagnosis codes for PPD test
 Q What is the correct ICD-9 code for the purified  protein derivative (PPD) skin test, CPT code 86580?
 A ICD-9 code V74.1 represents a special screening  examination for pulmonary tuberculosis, including diagnostic skin testing for  the disease. Often code V70.5, "Health examination of defined subpopulations,"  may be a secondary diagnosis to indicate the test is performed as part of a  pre-employment or occupational health examination. Additional ICD-9 codes may be  reported to indicate the patient's risk for tuberculosis. For example, report  V01.1 for "Contact with or exposure to tuberculosis," 042 for HIV infection or  793.1 for "Nonspecific abnormal findings of radiological and other examination  of the lung field."
 Remember that when a patient returns for the PPD reading, even  when the reading is done by a nurse working incident to your services, you may  report code 99211 for this evaluation and management (E/M) service.


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