Otolaryngology Coding Alert
Recognize Allergy Testing Includes Reviewing Results With Patients
Question: Following allergy testing, the physician meets with the patient to go over the results. The doctor requests that we submit an E/M code in addition to the allergy testing. Is this allowed? Arkansas Subscriber Answer: No, the physician should not bill an evaluation and management (E/M) service to go over the test results following allergy testing. Inclusive in the patient’s allergy testing is time with the patient to review the results of the testing. For confirmation of this, you should look no further than the following CPT® guidelines located in the Medicine chapter at the beginning of the allergy testing procedures (95004-95070): “Do not report E/M services for test interpretation and report. If a significant, separately identifiable E/M service is performed, the appropriate E/M service code should be reported using modifier 25 (Significant, separately identifiable evaluation and management service by the same physician … on the same day of the procedure or other service).” This means that if your physician wants to submit a separate E/M visit alongside the allergy testing, the reasoning for billing the E/M must be distinct from that of the allergy testing.
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Recognize Allergy Testing Includes Reviewing Results With Patients
Question: Following allergy testing, the physician meets with the patient to go over the results. The [...]
