Allergy Coding Alert
You Be the Coder: Don't Confuse End Point Titration and Intradermal Tests
Question: We perform end point titration skin testing using 95028 when testing for foods and 95024 for testing inhalants. Is this correct?
Texas Subscriber
Answer: You should report end point titration skin testing with 95027 (Intracutaneous [intradermal] tests, sequential and incremental ...) whether the test is for foods or inhalants. Allergists use this technique with immunotherapy to determine a starting point for a patient's allergen (antigen) sensitivity. Generally, the physician conducts three tests (dilutions) per allergen to determine the end point. Carriers pay these tests per antigen or per stick, depending on the payer. Keep in mind that physicians use this technique infrequently, so Medicare carriers may monitor the use of 95027.
End point titration tests are distinct from intradermal tests, which you should report using 95024 (Intracutaneous [intradermal] tests with allergenic extracts, immediate type reaction, specify number of tests) and 95028 (Intracutaneous [intradermal] tests with allergenic extracts, delayed type reaction, including reading, specify number of tests). Code 95028 describes a delayed identification, meaning the patient would return several days later to obtain the test results.
Medicare carriers accept a limited number of diagnoses to justify billing 95024, 95027 and 95028. Check your individual carrier's local medical review policy (LMRP) for a complete list of applicable ICD-9 codes.
Note: You can find many carriers' LMRPs by searching www.lmrp.net.
- Published on 2003-09-15
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