Pulmonology Coding Alert

Question: Our local carrier requires us to use 95024 for our skin testing. We have been using 95027. Which is the correct way to code for this type of allergy testing?

Kentucky Subscriber Answer: Pulmonologists administer intracutaneous tests (95024, Intracutaneous [intradermal] tests with allergenic extracts, immediate type reaction, specify number of tests) using allergenic extracts. Report 95024 according to the number of tests the physician performed.
 
CPT 2003 revised 95027 (Intracutaneous [intradermal] tests, sequential and incremental, with allergenic extracts for airborne allergens, immediate type reaction, specify number of tests) to describe airborne allergen tests that use various diluting strengths. This test method analyzes the highest dilution of a substance that produces a reaction with a given concentration of another substance.
 
If your Medicare carrier requires you to report a service with a CPT code that differs from the actual service provided, consider two things:
 
 Make sure the carrier representative fully understands the procedure that your pulmonologist performs and the CPT descriptions that represent that service.
 
 If the carrier insists on a different code, get the instruction in writing to prove you followed the payer's requirements.   - Answers for You Be the Coder and Reader Questions were provided by Carol Pohlig, BSN, RN, CPC, senior coding and education specialist at the University of Pennsylvania department of medicine in Philadelphia; and Anthony M. Marinelli, MD, FCCP, chairman of the American Thoracic Society's Clinical Practice Committee.