Wiki Allergy Testing

TMB1965

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Does anyone know how many units Medicare allows for the 95004? I heard 20 units per year or is that for a different Allergy test?
 
Here is brief answer for your question
The selection of antigens should be individualized, based on the history and physical examination.

Medicare expects that all patients will not be tested for the same antigens or receive the same number/type of tests.

Medicare would not expect that more than 75 percutaneous tests per year are medically necessary for the management of an individual patient. More than 75 tests per year may be allowed upon review when the clinical circumstances documented in the patient?s medical record substantiate the need for additional tests.

Medicare would not expect that more than 20 intradermal tests per year are medically necessary for the management of an individual patient. More than 20 tests per year may be allowed upon review when the clinical circumstances documented in the patient?s medical record substantiate the need for additional tests.

Medicare would not expect allergy patch testing to be routinely done on an annual basis. Rather it should be reserved for those patients whose occupational or environmental exposures have caused an allergic contact dermatitis, the cause of which cannot be determined by usual historical or clinical means.

Medicare would not expect that more than 30 patch tests (a standard series of 24 allergens with controls or individual patch test allergens) per beneficiary per year is medically necessary for the management of an individual patient. The medical necessity of the frequency of patch testing must be documented in the medical record.
 
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