We do patch testing in our office. We apply the test on Monday and the patient comes back for readings in 48 hours, 96 hours, and a 7 day reading. Our MD goes over the results and we give education and print out on avoidance if there are any positive findings. We also send an email to the patient containing a safe list of products to use. Our nurse reads the test and renumbers the areas so the chemicals can match up to the sheet. Our billing bills the test on Monday then we bill nurse visit on the 48 hour and 96 hour visit (unless the MD sees them on the 96 hour) and then bill OV on 7 day reading because of all the education and information given with positive findings. If there is negative findings then the MD will look at different treatment plan or causes. With the new guidelines are we only allowed to bill for the test? There is a lot of work into these appointments and information/education given to the patients that I feel and E/M should be counted on the last visit. The test itself does not reimburse what the MD feels is acceptable.