Wiki We need help please

caseynix

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Thomasville, GA
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We do allergy testing in our office. After the allergy test the patient comes back on another day for a vial test. For that we have been charging 95024 & 95117 on the same day and were getting paid. Now we are not getting paid for the 95024 ( Payment is included in the allowance for another service/procedure). Please HELP! Thank you in advance
 
95024 bundles with 95117 per CCI Edits based on Standards of medical / surgical practice.

"Standards of medical/surgical practice: Under Medicare, all services necessary to complete a procedure based upon standard medical/surgical practice are included in the procedure. Many procedures that are typically necessary to complete a more comprehensive procedure have been assigned independent HCPCS/CPT codes because they may be performed independently in other settings. The service described by HCPCS/CPT code ____ (the column two HCPCS/CPT code) is typically included when performing the procedure described by HCPCS/CPT code ____ (the column one HCPCS/CPT code) and is therefore bundled into HCPCS/CPT code _____(the column one HCPCS/CPT code.)"

During the immunotherapy, the patient is being injected with substances that are known to cause an allergic reaction, so the body will inevitably react. If the immunotherapy is done prior to the testing, the results of the testing will obviously be inaccurate. Likewise, if the testing occurs first and the patient has a reaction, the body is already in "reaction mode" when the patient then has the immunotherapy done second. A modifier is allowed here, but I can't think of a situation where that would be applicable.
 
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