Reader Question:
Fight For The Right To Report 95117, 95024 Separately
Published on Mon Oct 10, 2011
Question: The payer denied our claim for CPT 95117 and 95024 on the basis of CCI edits, but I can't find any documentation on the edits. The American Academy of Otolaryngic Allergy (AAOA) requires that once a patient is skin tested (95024) when they return to the office for their first allergy injection (95117), the nurse must administer a "vial test" to ensure the serum is not too strong. What did we do wrong?Nevada SubscriberAnswer: You are right. CPT®s 95117 (Professional services for allergen immunotherapy not including provision of allergenic extracts; 2 or more injections) and 95024 (Intracutaneous [intradermal] tests with allergenic extracts, immediate type reaction, including test interpretation and report by a physician, specify number of tests) are not bundled. You are performing 95024 on the same day as the initial injections as the proper protocol set forth by the AAOA, but the payers do not necessarily agree with [...]