Wiki patch testing

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CMBA4

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Hi all!,

Our office wants to being offering patch testing CPT 95044, does any one know how the insurance companies will typically reimburse for this procedure? We are located in Nassau County, NY.

Are there any pitfalls to be aware of when billing certain carriers? IE. Commercial Carriers, Medicare?

Thank you!
D
 
Our Medicare (in South Florida) reimburses just under $6 per test (we do 36 tests) and the other carriers reimburse similarly.

Notes:
1. Bill by units on a single line
2. You will need a referral for HMO patients
3. Check for LCDs that may limit the diagnoses you can bill for
4. There are zero global days, and you can perform an unrelated surgical procedure on the same day as a patch test without any modifiers.
5. My understanding regarding billing for office visits is that you can bill an office visit when the doctor meets with the patient to decide on the need for the testing, as well as for the visit after the testing to discuss the results and give recommendations, but you CANNOT bill for an office visit just for applying or removing the patches or checking the sites, as those services are included in the 95044.
 
You're welcome!

I have looked further into the issue of billing office visits and have been told that if a doctor reads the sites upon removal of the patches (or upon return visit following removal), it is billable as an office visit. I can't guarantee that this is accurate; it's just what I was told by a doctor who does a lot of patch testing.
 
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