CPT for ENT: Intradermal Dilutional Testing

CPT for ENT: Intradermal Dilutional Testing

Q.Should physicians report CPT code 95027 by antigen or per dilution (test or stick)? 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

A.The change for the code descriptor for CPT code 95027 was documented in the American Medical Association’sCPT® Changes 2003: An Insider's View. Formerly describing skin end point titration testing, CPT Code 95027 now refers to intradermal dilutional testing. It should be reported by the number of sticks or tests performed per allergen at the various levels of dilution.  For example, if a physician administers 10 allergens at 4 concentration levels for each antigen, he or she would report this as 95027 with 40 units of service. According to American Medical Association’s Current Procedural Terminology CPT® 2008 Changes, CPT code 95027 does not include history and physical services. Furthermore, CPT code 95027 includes the test interpretation and report by a physician, so you should not report these separately with Evaluation and Management (E/M) Services. If the physician performs a distinct and separately identifiable E/M, on the same date of service as the intradermal dilutional tests, he or she can report this with an appropriate E/M code, appending modifier 25 - Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Serviceto it.

Approved November 2009