Wiki Allergy Testing-I audit work

[MALC]

I audit work comp claims and I have a provider that billed 99213 (note stated 48 hrs patch test reading) two (2) days after allergy testing (95044) and then another 99213 four(4) days after testing. CPT code 95044 does not have any global days, BUT the CPT book states “do not report E/M services for test interpretation and report. If a significant separately identifiable E/M service is performed, the appropriate E/M service code should be reported using modifier 25.” So does this mean you can't bill E/M's for the test interpretations and reports 2 or 4 days later? Or on the same day? Thanks for your help

 

[EARREYGUE]

Sounds like over billing

I have an allergy clinic, we dont use this code but, just my thoughts this sounds like over billing, If the guidelines state not to report E&M for interpretation and report this means its include. If there was a global period this would definitely not get paid especially for the same diagnosis. If you haven't had any problems with payment that may be why.