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Allergy testing help

  1. Question Allergy testing help
    Exam Training Packages
    I would like to know if the positive and negative test done prior to the actual allergy tests should be included in the total testing count. Thank you

  2. Default Allergy Testing
    Please reference the two documents copied below:

    Prick Technique: The prick technique involves introducing a small amount of allergen into the skin by making a small puncture through a drop of the allergen extract. If you have an allergy, the specific allergens that you are allergic to will cause a chain reaction to begin in your body.

    People with allergies have an allergic antibody called IgE (immunoglobulin E) in their body. This chemical, which is only found in people with allergies, activates special cells called mast cells. These mast cells release chemicals called mediators, such as histamine, the chemical that causes redness and swelling. With testing, this swelling occurs only in the spots where the tiny amount of allergen to which you are allergic has been introduced. So, if you are allergic to ragweed pollen but not to cats, the spot where the ragweed allergen touched your skin will swell and itch a bit, forming a small dime-sized hive. The spot where the cat allergen scratched your skin will remain normal. This reaction happens quickly within your body.

    Test results are available within 15 minutes of testing, so you don't have to wait long to find out what is triggering your allergies. And you won't have any other symptoms besides the slightly swollen, small hives where the test was done; this goes away within 30 minutes.

    Intradermal: involves injecting a small amount of allergen under the skin with a syringe. This form of testing is more sensitive than the prick skin test method. This form of allergy testing may be used if the prick skin tests are negative.

    ©2007, American Academy of Allergy, Asthma and Immunology. All rights reserved. May not be duplicated or appropriated without permission. For copyright permission, please email Marianne Canter, Director of Communications and Membership, at

    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

    Need anything else, just ask!

  3. #3
    Jacksonville, FL
    Default CPT 95027 and units
    posted in error
    Last edited by CoderinJax; 10-20-2009 at 09:06 AM.

  4. Default
    I am in need of documentation stating what "interpretation and report" must consist of.

    Our RN does the testing and fills out the testing form which lists negatives and positives.

    the MD signs at the bottom that they have reviewed the results and agree with them and will discuss treatment option with the patient at the next visit.

    is that enough?
    Rachell Lindley, CPC
    Multispecialty Clinic Coding
    Internal Medicine
    General Surgery
    Family Medicine

  5. Default Allergy Testing billing by Physician off-site
    Can a ENT MD send thier staff member RN or PA to render allergy testing at the office where there referral is provided. The billing physician (ENT MD) is not present on site and the only present physician is the referring doctor. Can the ENT bill for the service performed by his staff on the remote location?

  6. Default
    No- whomever is providing the supervision is the one who needs to be billed under. AND whomever is providing th supervision is expected to have knowlege in allergy testing so that if a question, concern comes up they can be consulted and provide correct information and direction to the RN.
    Rachell Lindley, CPC
    Multispecialty Clinic Coding
    Internal Medicine
    General Surgery
    Family Medicine

  7. Default Cpc
    I have a question...does anyone have a CPT for Pathergy Skin Testing or would this be part of the MDM for the E/M code?

  8. Default Medicare Billing CPT 95024

    I am in Jurisdiction E and have Noridian as my MAC. We are trying to bill CPT 95024 and Noridian will not tell us the max number of units. We tried billing 41 units because she did 41 tests. Does anyone know what is the max number of units? Is there a way we can bill for all 41 tests and get paid for it (i.e. spread it out over days)?



  9. Question ABNs and Precutaneous Tests
    We're starting to do percutaneous allergy testing in our office and I'm wondering when billing if we should have our patients sign an ABN for the service. I'm not sure what coverage people are generally seeing with the 95004 code, but we are an ND primary care office so I just want to make sure since we already walk a fine line.

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