Pediatric Coding Alert

Question: Should I use CPT 95024 or 95027 for allergy skin tests? Also, should I code based on the number of allergens tested or sticks performed? For example, when testing for allergies to Bermuda grass, if the nurse sticks the child three times, should I charge for only one test or for three sticks?

Georgia Subscriber

Answer: You should select 95024 (Intracutaneous [intradermal] tests with allergenic extracts, immediate type reaction, specify number of tests) or 95027 (Intracu-taneous [intradermal] tests, sequential and incremental, with allergenic extracts for airborne allergens, immediate type reaction, specify number of tests) based on whether the pediatrician or ancillary staff perform one stick or multiple sticks per allergen. If the physician performs only one stick or test per allergen, you should report 95024, which describes straight intradermal testing.

On the other hand, when the staff member performs tests of increasing strength to determine the child's safe starting dose for immunotherapy, you should report 95027 for sequential and incremental allergy testing. Because the nurse in your example performs multiple sticks per allergen, you should report 95027 (Intracutaneous [intradermal] tests, sequential and incremental, with allergenic extracts for airborne allergens, immediate type reaction, specify number of tests). Each unit represents one stick or dilutional test per antigen, so for three sticks of progressing amounts of one allergen, you should report 95027 x 3.