Dermatology Coding Alert
Look to 95004-95028 for Intradermal Allergy Testing
Question: When we perform allergy testing, we bill 86003. Should we use 95004? Answer: For allergy testing, you should probably use 95004 or 95010.
North Carolina Subscriber
When the dermatologist orders in vitro tests, such as RAST (radioallergosorbent tests), FAST (fluorescent allergosorbent tests) or ELISA (enzyme-linked immunosorbent assay), you should use 86003 (Allergen specific IgE; quantitative or semiquantitative, each allergen). To report the lab code, your office must analyze the specimen, not merely send it to a lab.
Most carriers, commercial and Medicare, will not pay for these tests except under certain conditions. Insurers may cover the tests when the patient is a child under 4.
If you instead perform percutaneous or intracutaneous allergy testing, you should assign the appropriate code from the allergy testing series (95004-95078).
For scratch, puncture or prick tests, report 95004 (Percutaneous tests [scratch, puncture, prick] with allergenic extracts, immediate type reaction, specify number of tests) or 95010 (Percutaneous tests [scratch, puncture, prick] sequential and incremental, with drugs, biologicals or venoms, immediate type reaction, specify number of tests).
If you administer intradermal tests, you should instead assign 95015-95028. Choose the right allergy test code based on the type of test and the allergens:
Dermatology Coding Alert
- Reporting Debridement Separately From Wound Repair? Maximize Pay With These Tips
Look for devitalized or contaminated tissue to justify 11040 Many clinical scenarios do not require [...] - ICD-9 Coding:
Take the Rough Edge Off Corn And Callus Coding
Warning: These little-known terms may show up in your doctor's documentation For dermatologists treating the [...] - Avoid Being Swamped by Recent CMS Releases -- Here's How
Missing the surrogate UPIN change guarantees denials You've made it through half the year, but [...] - Same Group, Different Specialty:
Collect What You Deserve
Stand your ground when your carrier shoots you down on new patient visits Watch out: [...] - Reader Questions:
Carriers Differ on Dermabond Coding Rules
Question: An elderly patient had a 1.4-centimeter skin tear on his left thigh. The dermatologist [...] - Reader Questions:
3 or 4 HPI Elements Play Big Role in E/M Level
Question: How does a brief history of present illness (HPI) differ from an extended HPI?
Michigan [...] - Reader Questions:
Check Wound Size Before You Code Wound Care
Question: Our dermatologist saw a patient status post bilateral wrist arthroplasty and he debrided two [...] - Reader Questions:
Make Sure You Meet Incident-To Criteria
Question: We have a new physician assistant in our office who sees patients for the [...] - Reader Questions:
Find Medicare LCD in 1 Stop
Question: Where can I go to look up Medicare carriers' local coverage determinations? Also, is [...] - You Be the Coder:
Get Specific With Decubitus Ulcer Diagnosis
Question: A patient had decubitus ulcers on his right hip and buttock. The dermatologist debrides [...] - Reader Questions:
Don't Mix Modifiers
Question: I'm always at a loss on whether to use modifier 25 or modifier 57 [...] - Reader Questions:
Look to 95004-95028 for Intradermal Allergy Testing
Question: When we perform allergy testing, we bill 86003. Should we use 95004?
North Carolina Subscriber [...]
