TTcpc
Guru
Hello,
I was wondering how your clinics handle oral food challenges - specifically when the testing has to stop secondary to a reaction that is treated.
From what I found from the AAAAI, 3M and the CPT book, if a patient has a treatable reaction to an oral food challenge, you should stop the clock for the testing time and if over 60 min of testing time were spent you can bill the 95076, bill for the meds (Epi,injectibles) and then the remainder of the time spent monitoring for recurrence or worsening of reaction as an E/M based on time. The problem is with the 2021 guidelines, unless it's the physician or APP is sitting in the room with the patient during that time themselves, we can't. Not sure about other practices, but we use trained RNs to monitor and the MD/APP is there in the clinic readily available to respond and do check in the room from time to time to see how the patient is. Also, we may have more than one patient in the clinic at a time having testing done.
Do your MDs/APPs stay in the room the remainder of the time the patient is there for observation and if clinical staff/RN how do you account for their time from a practice expense standpoint.
Any assistance/opinions would be greatly appreciated!
I was wondering how your clinics handle oral food challenges - specifically when the testing has to stop secondary to a reaction that is treated.
From what I found from the AAAAI, 3M and the CPT book, if a patient has a treatable reaction to an oral food challenge, you should stop the clock for the testing time and if over 60 min of testing time were spent you can bill the 95076, bill for the meds (Epi,injectibles) and then the remainder of the time spent monitoring for recurrence or worsening of reaction as an E/M based on time. The problem is with the 2021 guidelines, unless it's the physician or APP is sitting in the room with the patient during that time themselves, we can't. Not sure about other practices, but we use trained RNs to monitor and the MD/APP is there in the clinic readily available to respond and do check in the room from time to time to see how the patient is. Also, we may have more than one patient in the clinic at a time having testing done.
Do your MDs/APPs stay in the room the remainder of the time the patient is there for observation and if clinical staff/RN how do you account for their time from a practice expense standpoint.
Any assistance/opinions would be greatly appreciated!