Advanced Search

CPT® 95004, Under Allergy Testing Procedures

The Current Procedural Terminology (CPT®) code 95004 as maintained by American Medical Association, is a medical procedural code under the range - Allergy Testing Procedures.

Get the full picture on this code.

Start a FREE 2-WEEK TRIAL of Codify by AAPC.

FOR INDIVIDUALS FOR TEAMS

Additional/Related Information

Tabs
Summary

The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.

 

 

For clinical responsibility, terminology, tips and additional info
start codify free trial.

View any code changes for 2026 as well as historical information on code creation and revision.

Crosswalks

Tabs
Combat the #1 denial reason - mismatched CPT-ICD-9 codes - with top Medicare carrier and private payer accepted diagnoses for the chosen CPT® code.
View the CPT® code's corresponding procedural code and DRG. In a click, check the DRG's IPPS allowable, length of stay, and more. To plug inpatient facility revenue drains, subscribe to DRG Coder today.
Crosswalk to an anesthesia code and its base units, and calculate payments in a snap! Subscribe to Anesthesia Coder today.
View matching HCPCS Level II codes and their definitions.

Forum

Have a question about CPT Code 95004 ? Start a discussion here
Allergy Testing Medicare Denials
[QUOTE="JennMagg, post: 501471, member: 612004"] We just started seeing A TON of denials for allergy skin testing (CPT 95004) from Medicare. They said it's due to medical necessity/insufficient docume... [ Read More ]
Allergy Testing Medicare Denials allergy allergy testing lcd medicare
We just started seeing A TON of denials for allergy skin testing (CPT 95004) from Medicare. They said it's due to medical necessity/insufficient documentation and that we have been using non-covered I... [ Read More ]
E/M plus procedures
Patient came in for an annual physical but also was treated for allergies and abdominal pain, do I append modifier 25 to the E/M and no modifiers for the procedures or do I add modifier 59 ( distinct ... [ Read More ]
Denials for CPT 95004 with E&M Code allergy skin testing
I’m starting to get a lot of denials when we code CPT code 95004 (allergy skin testing) with any kind of E&M. We apply a 25 modifier but they still want to bundle it. Even with UHC when we have to s... [ Read More ]
Wyoming- Allergy Billing
I am in Wyoming and we just received a letter from BCBS-WY stating they are changing how they pay for allergy testing. We use the codes 95004, 95024, and 95027. For a normal Multi test (95004, 95024) ... [ Read More ]
Insurance taking money back
I have a patient that BCBS TN took money back on from DOS 11/18. This claim was for new patient visit with allergy testing. We also mixed the allergy serum on the same DOS but was on a different claim... [ Read More ]
Direct supervision requirements and incident to for diagnostic allergy testing 95004 95024 supervision
Hello, I need help with a scenario so we can get the workflow correct in our clinic. I understand diagnostic allergy testing 95004 and 95024 have a requirement for direct supervision and this superv... [ Read More ]
Provider Fee Calculations
Can anyone assist me on the formula to calculate a physician's fee for a CPT (95004 & 95165)? Any help would greatly be appreciated. Thank you... [ Read More ]
Icd-10 selection for cpt 95004 prick test
[QUOTE="MNJACOBS, post: 433592, member: 473873"]Receiving denials from Medicare because coders are using the negative result of the allergy testing (Z78.9) as the primary dx which does not meet med ne... [ Read More ]
Icd-10 selection for cpt 95004 prick test
Receiving denials from Medicare because coders are using the negative result of the allergy testing (Z78.9) as the primary dx which does not meet med necessity per LCD policy. Is this following correc... [ Read More ]
View All

Coding Alert(s)

    Read a CPT® Assistant article by subscribing to Code Connect Today!
    Search across Medicare Manuals, Transmittals, and more. For FREE Trial, register now!

    Latest News

    2025 Brings New Telemedicine Codes
    But only one is reimbursable under Medicare. For calendar year 2025 the American Medical Association AMA introduced a new set of telemedicine codes CPT 9800098016 for reporting patient evaluation and ... [ Read More ]
    AAPC Ambassador Committee Officially Underway
    This new group of volunteer leaders provides even more member support. When it comes to professional development AAPC has long stood out as a place where members help each other. Now with the launch o... [ Read More ]
    Advice From a CRHC
    AAPC member Caliay Picard CPC CDEO CPMA CRC CRHC has worked in healthcare for more than 10 years eight of which were devoted to coding. While Picard still codes on occasion her focus now is the coding... [ Read More ]
    Become a Revenue Cycle Management Specialist
    If youre looking to move up the RCMS certification by AAPC is the next step in your career journey. AAPC is pleased to announce its newest certification Revenue Cycle Management Specialist RCMS. As wi... [ Read More ]
    Find Codes With Code Constructor
    Codify by AAPC makes it easy to drill down to the most specific code. Whats your preferred way to get to the code you need AAPC by Codify offers various options from the index and keyword search to th... [ Read More ]
    View All News