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pediatric TB testing

  1. Default pediatric TB testing
    Medical Coding Books
    Does anyone know if there's a CPT code for reading a TB test? I know the CPT for placing one is 86580.

    Any information would be greating appreciated!

    -Donna

  2. #2
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    There really isn't a CPT for the reading of TB testing. You can use a 99211 because a nurse had to look at the site and then place the dx code of 795.5, which is nonspecific reation to tB skin test without active TB.
    [I]Elizabeth Comma-Watson, CPC
    Billing/Coding Specialist
    Greensboro, NC 27455-2601

  3. #3
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    I would not suggest billing anything unless the patient is positive,because at that time the doctor would need to be called in.I've worked in Peds for years we dont bill because the nurse looks and checks off,also remember 99211 sometimes will required a copay for some insurances.I would be upset as a patient to pay a $20.00 copay for a nurse to see my childs arm that takes seconds.The coders here really believe that is still part of the visit at the time the TB was given.

  4. #4
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    I agree with EARREYGUE. I would not use 795.5 as it states in the description "PPD positive".

  5. #5
    Thumbs up
    Quote Originally Posted by EARREYGUE View Post
    I would not suggest billing anything unless the patient is positive,because at that time the doctor would need to be called in.I've worked in Peds for years we dont bill because the nurse looks and checks off,also remember 99211 sometimes will required a copay for some insurances.I would be upset as a patient to pay a $20.00 copay for a nurse to see my childs arm that takes seconds.The coders here really believe that is still part of the visit at the time the TB was given.


    I total agree with Earreygue......


    YTH,CPC

  6. Default
    Thanks so much for everyone's feedback! This question came up from a non experienced coder from another office & I told her I would post this bullentin to see what type of responses I got back......Yes I do agree with not charging the PT an office visit to read the TB test and we have honestly never charged for the reading. The DX code that was givent to use would be incorrect since it does state its active TB. thanks again for everyone that replied to this post!

  7. #7
    Location
    Cape Girardeau, MO
    Posts
    11
    Default
    I realize that this is an older thread but I found it on accident & I wanted to share current information. Per Appendix C in the CPT book which is clinical examples, it is appropriate to bill 99211 to read TB test results. However, the book does use a 42 year old for an example & with regards to children, your office policy or even payer policy may differ.
    C Darlene Ury, CPC

  8. #8
    Location
    Kansas City Chapter
    Posts
    33
    Default
    Also, in Coding for Peds 2013 page 235 it also states it is appropriate to bill a 99211 to report the reading of a PPD test. The appropriate DX code is V74.1 ( special screening examination for bacterial and spirochetal diseases)

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