Wiki Need help with 86003 - allergy testing

[sooloo66]

Hi -

We have a new doctor on board who does a lot of allergy testing. He is doing the RAST allergens, but only dropping the 86003 code once. I am not familiar with allergy testing.

Does he need to code for each allegen that he is testing for? Do I need to append a modifier to each?

Thanks for any help!

 

[danachock]

86003 coding

Hi - oh my this is sounding like it is being billed out wrong ~

86003 is for each IgE that is being tested.
Our location sends these to another facility to be processed.
First billable item only has the 90 modifier and each additional IgE has a 90,91 modifier on it.

Also pay super close attention to your denials. I have one insurance company that requires me to bill these laboratory tests out as a quantity instead of individually for each lab being done.

I hope this helps,

Dana Chock, CPC, CCA, CANPC, CHONC
Anesthesia, Pathology & Laboratory Coder

 

[sooloo66]

Thanks for the reply. We definitely need to change the way this is being done!

 

[Linda McMann]

Our office does a quantity of 36 allergens and we bill it out as 86003 x36 and we get paid as long as there is appropriate medical necessity for the testing .