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Allergy injections

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    Exam Training Packages
    For 95004 I understand that they changed the verbiage in 2008 to include interpretation and report. Does this mean that there needs to be a separate interpretation and report by the physician, not just a sentence within the medical note for that date of service? Thanks

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    What admin code would you use?


    Quote Originally Posted by Anna Weaver View Post
    Here's what CPT assistant has to say:

    Allergy injections and diagnostic tests
    CPT Assistant, December 2007 Page: 9 Category: Coding Consultation
    CPT Coding for Allergy Injections and Allergy Diagnostic Tests

    Allergy Injections

    Allergy injections are reported using CPT codes 95115 for a single injection and 95117 for two or more injections. These codes describe the administration (injection) of the allergenic extract when the extract provision or preparation of the extract is not included in the code descriptor. They do not include the provision or preparation of the extract. Codes 95115 and 95117 are intended to be reported one time, regardless of the number of injections administered. These services are typically performed by a nurse and do not include physician work. If the physician performs an evaluation and management (E/M) service on the same day as an injection, the physician should document the service and report the appropriate level E/M service code. In cases when there is no physician history or exam performed but the nurse must consult with the physician as to whether the patient should receive the injection and whether dosage adjustments are required (eg, the patient is ill or reports a reaction to the last injection), CPT code 99211 would be appropriate.

    Allergy Diagnostic Tests

    95004 Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction, including test interpretation and report by a physician, specify number of tests

    95024 Intracutaneous (intradermal) tests with allergenic extracts, immediate type reaction, including test interpretation and report by a physician, specify number of tests

    95027 Intracutaneous (intradermal) tests, sequential and incremental, with allergenic extracts for airborne allergens, immediate type reaction, including test interpretation and report by a physician, specify number of tests

    Effective January 1, 2008, the descriptors for the allergy diagnostic test codes (CPT codes 95004, 95024, and 95027) have been modified to clarify that the service includes "test interpretation and report by a physician." In addition, Centers for Medicare & Medicaid Services (CMS) now recognizes physician work for CPT codes 95004, 95024, and 95027. Furthermore, the Allergy and Clinical Immunology guidelines have been modified to indicate that when reporting any allergy testing on the same day as a significant, separately identifiable E/M service, modifier 25 must be appended to the E/M service code.




    CPT Assistant © Copyright 1990–2008 American Medical Association. All Rights Reserved

    Maybe this will help?
    Belinda Ziegman M.A. CPC

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