Pediatric Coding Alert

Question: Can I code CPT 99211 for tuberculosis (PPD) checks? What is the corresponding diagnosis code?

Texas Subscriber

Answer: You can code 99211 (office or other out-patient visit for the evaluation and management of an established patient, that may not require the presence of a physician) for reading the test, but not all insurers may accept it. If the insurer rejects the claim, you can choose either to appeal or to bill the parent directly.

For a routine screen, you should use a diagnosis of V20.2 (routine infant or child health check). Some health plans will allow you to use this diagnosis a limited number of times per year (usually only once unless the child is an infant). A second diagnosis option is V74.1 (special screening examination for bacterial and spirochetal diseases), which can also be used when administering a PPD test.