Dermatology Coding Alert

Question: A physician tests a patient, who complains of skin rashes, for reactions to dogs, cats, ragweed, oak, maple, penicillin, dust mites, and bees. How should I report 95004 and 95010?

Florida Subscriber

Answer: You should report 95004 (Percutaneous tests [scratch, puncture, prick] with allergenic extracts, immediate type reaction...) x 4 units for the ragweed, oak, maple, and dust mites, and 95010 (Percutaneous tests [scratch, puncture, prick] sequential and incremental, with drugs, biologicals or venoms, immediate type reaction, including test interpretation and report by a physician, specify number of tests) x 4 units for the dog, cat, penicillin, and bee stings.

A dermatologist has many ways of determining the cause of a patient's skin rashes. Moreover, they usually want to test several substances at once. Bear in mind that each substance counts as a separate test. Be sure to code for each allergen administered by putting the number in the "units" field of your claim form.

Quick Fact: The percutaneous test is also known as scratch test, prick test or puncture test. Here, the dermatologist applies test solutions of possible allergens to scratches or shallow punctures on a patient's skin.

The type of solutions your dermatologist applies will determine the code you report: 95004 for allergenic extracts and 95010 for antibiotics, biologicals, stinging insects, and local anesthetic agents.