Pulmonology Coding Alert

Reader Questions:

No Injection Code For 86580

Question: I'm not sure whether to use an E/M code or 86580 for tuberculosis skin tests. Can I report the injection separately?Michigan SubscriberAnswer: The physician would typically perform an initial purified protein derivative (PPD) for tuberculosis skin screening. You should report this with 86580 (Skin test; tuberculosis, intradermal), and link V74.1 (Special screening examination for bacterial and spirochetal diseases; pulmonary tuberculosis) or V01.1 (Contact with or exposure to tuberculosis) with it.Don't fall into the trap of coding 99211 (Office or other outpatient visit for the evaluation and management of an established patient...) for PPD because this is incorrect. Note, however, that 86580 does not cover any follow-up care. Therefore, if the patient returns to the office to have the nurse evaluate the test's results, you may then report 99211 to some payers. Although some payers may permit billing a minimal E/M (e.g., 99211) for the reading, the patient will be [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Pulmonology Coding Alert

View All