SUPERSEDED LCD Reference Article Billing and Coding Article

Billing and Coding: Allergy Testing

A57473

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Draft Articles are works in progress and not necessarily a reflection of the current billing and coding practices. Revisions to codes are carefully and thoroughly reviewed and are not intended to change the original intent of the LCD.
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General Information

Source Article ID
N/A
Article ID
A57473
Original ICD-9 Article ID
Not Applicable
Article Title
Billing and Coding: Allergy Testing
Article Type
Billing and Coding
Original Effective Date
10/31/2019
Revision Effective Date
10/01/2022
Revision Ending Date
03/31/2024
Retirement Date
N/A

CPT codes, descriptions, and other data only are copyright 2023 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

Current Dental Terminology © 2023 American Dental Association. All rights reserved.

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Making copies or utilizing the content of the UB‐04 Manual, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions; and/or making any commercial use of UB‐04 Manual or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association. The American Hospital Association (the "AHA") has not reviewed, and is not responsible for, the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. The views and/or positions presented in the material do not necessarily represent the views of the AHA. CMS and its products and services are not endorsed by the AHA or any of its affiliates.

CMS National Coverage Policy

Title XVIII of the Social Security Act, Section 1833 (e) prohibits Medicare payment for any claim which lacks the necessary information to process the claim.

Title XVIII of the Social Security Act, Section 1862 (a) (1) (A) allows coverage and payment of those items or services that are considered to be medically reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.

Title XVIII of the Social Security Act, Section 1862 (a) (1) (D) excludes investigational or experimental from Medicare coverage.

Title XVIII of the Social Security Act, Section 1862 (a)(7). This section excludes routine physical examinations.

42 CFR, Section 410.20 – Physicians’ Services.

42 CFR Section, 410.32 tests not ordered by the physician or other qualified non-physician provider who is treating the patient are not reasonable and necessary. (See 42 CFR 411.15(k)(1).

42 CFR, Section 410.32(b) diagnostic tests must be furnished under the appropriate level of supervision by a physician. Services furnished without the required level of supervision are not reasonable and necessary.

CMS Pub 100-02 Medicare Benefit Policy Manual, Chapter 15 – Covered Medical and Other Health Services, Sections
20.2 – Physician Expense for Allergy Treatment,
80.1 – Clinical Laboratory Services, and
80.6 – Requirements for Ordering and Following Orders for Diagnostic Tests.

CMS Pub 100-03 Medicare National Coverage Determinations (NCD) Manual, Chapter 1 – Coverage Determinations, Part 2, Sections
110.9 – Antigens Prepared for Sublingual Administration
110.11 – Food Allergy Testing and Treatment
110.12 – Challenge Ingestion Food Testing
110.13 – Cytotoxic Food Tests.

CMS Pub 100-03 Medicare National Coverage Determinations (NCD) Manual, Chapter 1 – Coverage Determinations, Part 4, Section 230.10 – Incontinence Control Devices.

CMS Pub 100-04 Medicare Claims Processing Manual, Chapter 12 – Physicians/Nonphysician Practitioners, Section
200 - Allergy Testing and Immunotherapy.
Chapter 16 – Laboratory Services, Section
40.7 – Billing for Noncovered Clinical Laboratory Tests.

Article Guidance

Article Text

The billing and coding information in this article is dependent on the coverage indications, limitations and/or medical necessity described in the associated LCD Allergy Testing L36402.

Coding Information

Billing Guidelines
Evaluation and management codes reported with allergy testing is appropriate only if a significant, separately identifiable E/M service is performed. When appropriate, use modifier -25 with the E/M code to indicate it as a separately identifiable service. If E/ M services are reported, medical documentation of the separately identifiable service must be in the medical record. (CPT guidelines)

Allergy testing is not performed on the same day as allergy immunotherapy in standard medical practice. These codes should, therefore, not be reported together. Additionally, the testing becomes an integral part to rapid desensitization kits (CPT code 95180) and would therefore not be reported separately.

The MPFSDB fee amounts for allergy testing services billed under codes 95004-95078 are established for single tests. Therefore, the number of tests must be shown on the claim. (CMS Pub 100-04 Medicare Claims Processing Manual, Chapter 12 – Physicians/Nonphysician Practitioners, Section 200 – Allergy Testing and Immunotherapy, Rev.2997, Issued: 07-25-14, Effective: Upon implementation of ICD-10; 01-01-2012-ASC X12, Implementation: 08-25-2014 – ASC X12; Upon Implementation of ICD-10).

EXAMPLE

If a physician performs 25 percutaneous tests (scratch, puncture, or prick) with allergenic extract, the physician must bill code 95004, 95017 or 95018 and specify 25 in the units field of Form CMS-1500 (paper claims or electronic format). To compute payment, the Medicare contractor multiplies the payment for one test (i.e., the payment listed in the fee schedule) by the quantity listed in the unit’s field.

Part B providers indicate the actual number of tests (one for each antigen) in Box 24G of the 1500 claim form. (CMS Pub 100-04 Medicare Claim Processing Manual, Chapter 26 – Completing and Processing Form CMS-1500 Data Set, Section 10.4 – Provider of Service or Supplier Information, Rev. 3881, Issued: 10-13-17, Item 24G). On EMC claims enter the number in the service field.

Interpretation of CPT codes: 95004, 95017, 95018, 95024, 95027, 95028, 95044, 95052, and 95065 requires the number of tests which were performed. Enter 1 unit for each test performed. For example, if 18 scratch tests are done, code 95004, 95017 or 95018 with 18 like services. If 36 are done, code 95004, 95017 or 95018 with 36 like services.

When photo patch tests (e.g. CPT code 95052) are performed (same antigen/same session) with patch or application tests, only the photo patch testing should be reported. Additionally, if photo testing is performed including application or patch testing, the code for photo patch testing (CPT code 95052) is to be reported, not CPT code 95044 (patch or application tests) and CPT code 95056 (photo tests).

Non-covered services include, but are not limited to, the following services:

a. Sublingual Intracutaneous and subcutaneous Provocative and Neutralization Testing: Effective October 31, l988, sublingual intracutaneous and subcutaneous provocative and neutralization testing and neutralization therapy for food allergies are excluded from Medicare coverage because available evidence does not show that these tests and therapies are effective. (CMS Pub 100-03 Medicare National Coverage Determinations (NCD) Manual, Chapter 1, Part 2 Section 110.11 – Food Allergy Testing and Treatment (Rev. 1, 10-03-03).
b. Challenge Ingestion Food Testing: Challenge ingestion food testing has not been proven to be effective in the diagnosis of rheumatoid arthritis, depression, or respiratory disorders. Accordingly, its use in the diagnosis of these conditions is not reasonable and necessary within the meaning of §1862(a)(1) of the Act, and no program payment is made for this procedure when it is so used. (CMS Pub 100-03 Medicare National Coverage Determinations (NCD) Manual, Chapter 1, Part 2 Section 110.12 –Challenge Ingestion Food Testing (Rev. 1, 10-03-03).
c. Cytotoxic Food Tests: Prior to August 5, l985, Medicare covered cytotoxic food tests as an adjunct to in vivo clinical allergy tests in complex food allergy problems. Effective August 5, l985, cytotoxic leukocyte tests for food allergies are excluded from Medicare coverage because available evidence does not show that these tests are safe and effective. (CMS Pub 100-03 Medicare National Coverage Determinations (NCD) Manual, Chapter 1, Part 2 Section 110.13 –Cytotoxic Food Tests Rev. 1, 10-03-03).

Allergy testing is covered when clinically significant symptoms exist, and conservative therapy has failed. Allergy testing includes the performance, evaluation, and reading of cutaneous and mucous membrane testing, along with the physician taking a history including immunologic history, performing the physical examination, deciding on the antigens to be used, and interpreting results.

Counseling and prescribing treatment should be reported using a visit.
Do not report Evaluation and Management (E/M) services for test interpretation and report.

Standard skin testing is the preferred method when allergy testing is necessary. Each test should be billed as one unit of service per procedure code, not to exceed two strengths per each unique antigen. The number of antigens should be individualized for each patient based on history and environmental exposure.

A visit to an allergist, which yields a diagnosis of specific allergy sensitivity but does not include immunotherapy, should be coded according to the level of care rendered.

CPT procedure code 95060 is payable in place of service that include office, outpatient hospital (off-campus/on-campus), inpatient hospital, and emergency room – hospital settings.

Hospital Inpatient Claims:
Effective January 1, 2006, CMS is differentiating single allergy tests (“per test”) from multiple allergy tests (“per visit”) by assigning these services to two different APCs. CMS is assigning single allergy tests to newly established APC 0381 and maintaining multiple allergy tests in APC 0370.

Hospitals should report charges for the CPT codes that describe single allergy tests (or where CPT instructions direct providers to specify the number of tests) to reflect charges per test rather than per visit and bill the appropriate number of units of these CPT codes to describe all of the tests provided.

Coding Guidelines
Per the CMS Pub National Correct Coding Initiative (NCCI) Policy Manual for Medicare Services, Chapter 11- Medicine Evaluation and Management Services, CPT codes 90000-99999, K. Allergy Testing and Immunotherapy.

If percutaneous or intracutaneous (intradermal) single test (CPT codes 95004 or 95024) and "sequential and incremental" tests (CPT codes, 95017, 95018, or 95027) are performed on the same date of service, both the "sequential and incremental" test and single test codes may be reported if the tests are for different allergens or different dilutions of the same allergen. The unit of service to report is the number of separate tests. A single test and a “sequential and incremental” test for the same dilution of an allergen should not be reported separately on the same date of service. For example, if the single test for an antigen is positive and the physician proceeds to “sequential and incremental” tests with three additional different dilutions of the same antigen, the physician may report one unit of service for the single test code and three units of service for the “sequential and incremental” test code.

Photo patch tests (CPT code 95052) consist of applying a patch(s) containing allergenic substance(s) (same antigen/same session) to the skin and exposing the skin to light. Physicians should not unbundle this service by reporting both CPT code 95044 (patch or application tests) plus CPT code 95056 (photo tests) rather than CPT code 95052.
Evaluation and management (E/M) codes reported with allergy testing or allergy immunotherapy are appropriate only if a significant, separately identifiable service is performed. If E/M services are reported, modifier 25 should be utilized.

In general, allergy testing is not performed on the same day as allergy immunotherapy in standard medical practice. Allergy testing is performed prior to immunotherapy to determine the offending allergens. CPT codes for allergy testing and immunotherapy are generally not reported on the same date of service unless the physician provides allergy immunotherapy and testing for additional allergens on the same day. Physicians should not report allergy testing CPT codes for allergen potency (safety) testing prior to administration of immunotherapy. Confirmation of the appropriate potency of an allergen vial for immunotherapy is an inherent component of immunotherapy. Additionally, allergy testing is an integral component of rapid desensitization kits (CPT code 95180) and is not separately reportable.

The HCPCS/CPT code(s) may be subject to Correct Coding Initiative (CCI) edits. This policy does not take precedence over CCI edits. Please refer to the CCI for correct coding guidelines and specific applicable code combinations prior to billing Medicare. 

Response To Comments

Number Comment Response
1
N/A

Coding Information

Bill Type Codes

Code Description
N/A

Revenue Codes

Code Description
N/A

CPT/HCPCS Codes

Group 1

(17 Codes)
Group 1 Paragraph

Allergy Testing - Covered

Group 1 Codes
Code Description
82785 Assay of ige
86003 Allg spec ige crude xtrc ea
86008 Allg spec ige recomb ea
95004 Percut allergy skin tests
95017 Perq & icut allg test venoms
95018 Perq&ic allg test drugs/biol
95024 Icut allergy test drug/bug
95027 Icut allergy titrate-airborn
95028 Icut allergy test-delayed
95044 Allergy patch tests
95052 Photo patch test
95056 Photosensitivity tests
95060 Eye allergy tests
95065 Nose allergy test
95070 Bronchial allergy tests
95076 Ingest challenge ini 120 min
95079 Ingest challenge addl 60 min

Group 2

(2 Codes)
Group 2 Paragraph

Allergy Testing Non-covered

Group 2 Codes
Code Description
86001 Allergen specific igg
86005 Allg spec ige multiallg scr
N/A

CPT/HCPCS Modifiers

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

N/A

ICD-10-CM Codes that Support Medical Necessity

Group 1

(3,267 Codes)
Group 1 Paragraph

Note: Diagnosis codes must be coded to the highest level of specificity.

Allergy Testing 95004, 95017, 95018, 95024, 95027. For codes in the table below that requires a 7th character: letter A initial encounter, D subsequent encounter or S sequela may be used.

Group 1 Codes
Code Description
B44.81 Allergic bronchopulmonary aspergillosis
H10.11 Acute atopic conjunctivitis, right eye
H10.12 Acute atopic conjunctivitis, left eye
H10.13 Acute atopic conjunctivitis, bilateral
H10.31 Unspecified acute conjunctivitis, right eye
H10.32 Unspecified acute conjunctivitis, left eye
H10.33 Unspecified acute conjunctivitis, bilateral
H10.411 Chronic giant papillary conjunctivitis, right eye
H10.412 Chronic giant papillary conjunctivitis, left eye
H10.413 Chronic giant papillary conjunctivitis, bilateral
H10.44 Vernal conjunctivitis
H10.45 Other chronic allergic conjunctivitis
H16.261 Vernal keratoconjunctivitis, with limbar and corneal involvement, right eye
H16.262 Vernal keratoconjunctivitis, with limbar and corneal involvement, left eye
H16.263 Vernal keratoconjunctivitis, with limbar and corneal involvement, bilateral
H65.01 Acute serous otitis media, right ear
H65.02 Acute serous otitis media, left ear
H65.03 Acute serous otitis media, bilateral
H65.04 Acute serous otitis media, recurrent, right ear
H65.05 Acute serous otitis media, recurrent, left ear
H65.06 Acute serous otitis media, recurrent, bilateral
H65.21 Chronic serous otitis media, right ear
H65.22 Chronic serous otitis media, left ear
H65.23 Chronic serous otitis media, bilateral
H65.411 Chronic allergic otitis media, right ear
H65.412 Chronic allergic otitis media, left ear
H65.413 Chronic allergic otitis media, bilateral
H65.491 Other chronic nonsuppurative otitis media, right ear
H65.492 Other chronic nonsuppurative otitis media, left ear
H65.493 Other chronic nonsuppurative otitis media, bilateral
H66.91 Otitis media, unspecified, right ear
H66.92 Otitis media, unspecified, left ear
H66.93 Otitis media, unspecified, bilateral
J01.00 Acute maxillary sinusitis, unspecified
J01.01 Acute recurrent maxillary sinusitis
J01.10 Acute frontal sinusitis, unspecified
J01.11 Acute recurrent frontal sinusitis
J01.20 Acute ethmoidal sinusitis, unspecified
J01.21 Acute recurrent ethmoidal sinusitis
J01.30 Acute sphenoidal sinusitis, unspecified
J01.31 Acute recurrent sphenoidal sinusitis
J01.40 Acute pansinusitis, unspecified
J01.41 Acute recurrent pansinusitis
J01.80 Other acute sinusitis
J01.81 Other acute recurrent sinusitis
J01.90 Acute sinusitis, unspecified
J01.91 Acute recurrent sinusitis, unspecified
J04.0 Acute laryngitis
J04.30 Supraglottitis, unspecified, without obstruction
J04.31 Supraglottitis, unspecified, with obstruction
J05.0 Acute obstructive laryngitis [croup]
J30.0 Vasomotor rhinitis
J30.1 Allergic rhinitis due to pollen
J30.2 Other seasonal allergic rhinitis
J30.5 Allergic rhinitis due to food
J30.81 Allergic rhinitis due to animal (cat) (dog) hair and dander
J30.89 Other allergic rhinitis
J31.0 Chronic rhinitis
J31.1 Chronic nasopharyngitis
J31.2 Chronic pharyngitis
J32.0 Chronic maxillary sinusitis
J32.1 Chronic frontal sinusitis
J32.2 Chronic ethmoidal sinusitis
J32.3 Chronic sphenoidal sinusitis
J33.0 Polyp of nasal cavity
J33.8 Other polyp of sinus
J34.3 Hypertrophy of nasal turbinates
J34.81 Nasal mucositis (ulcerative)
J34.89 Other specified disorders of nose and nasal sinuses
J35.01 Chronic tonsillitis
J35.02 Chronic adenoiditis
J35.03 Chronic tonsillitis and adenoiditis
J35.1 Hypertrophy of tonsils
J35.2 Hypertrophy of adenoids
J35.3 Hypertrophy of tonsils with hypertrophy of adenoids
J45.20 Mild intermittent asthma, uncomplicated
J45.21 Mild intermittent asthma with (acute) exacerbation
J45.22 Mild intermittent asthma with status asthmaticus
J45.30 Mild persistent asthma, uncomplicated
J45.31 Mild persistent asthma with (acute) exacerbation
J45.32 Mild persistent asthma with status asthmaticus
J45.40 Moderate persistent asthma, uncomplicated
J45.41 Moderate persistent asthma with (acute) exacerbation
J45.42 Moderate persistent asthma with status asthmaticus
J45.50 Severe persistent asthma, uncomplicated
J45.51 Severe persistent asthma with (acute) exacerbation
J45.52 Severe persistent asthma with status asthmaticus
J45.901 Unspecified asthma with (acute) exacerbation
J45.902 Unspecified asthma with status asthmaticus
J45.909 Unspecified asthma, uncomplicated
J45.991 Cough variant asthma
J45.998 Other asthma
K20.0 Eosinophilic esophagitis
K29.30 Chronic superficial gastritis without bleeding
K29.60 Other gastritis without bleeding
L20.0 Besnier's prurigo
L20.81 Atopic neurodermatitis
L20.82 Flexural eczema
L20.84 Intrinsic (allergic) eczema
L20.89 Other atopic dermatitis
L23.9 Allergic contact dermatitis, unspecified cause
L24.9 Irritant contact dermatitis, unspecified cause
L25.9 Unspecified contact dermatitis, unspecified cause
L27.0 Generalized skin eruption due to drugs and medicaments taken internally
L27.1 Localized skin eruption due to drugs and medicaments taken internally
L27.2 Dermatitis due to ingested food
L27.8 Dermatitis due to other substances taken internally
L27.9 Dermatitis due to unspecified substance taken internally
L29.9 Pruritus, unspecified
L30.0 Nummular dermatitis
L30.2 Cutaneous autosensitization
L30.8 Other specified dermatitis
L50.0 Allergic urticaria
L50.1 Idiopathic urticaria
L50.3 Dermatographic urticaria
L50.6 Contact urticaria
L50.8 Other urticaria
R05.1 Acute cough
R05.2 Subacute cough
R05.3 Chronic cough
R05.4 Cough syncope
R05.8 Other specified cough
R06.02 Shortness of breath
R06.03 Acute respiratory distress
R06.09 Other forms of dyspnea
R06.2 Wheezing
R06.83 Snoring
R06.89 Other abnormalities of breathing
R09.81 Nasal congestion
R21 Rash and other nonspecific skin eruption
R43.0 Anosmia
R43.1 Parosmia
R43.2 Parageusia
R43.8 Other disturbances of smell and taste
T36.0X5A - T39.96XS Adverse effect of penicillins, initial encounter - Underdosing of unspecified nonopioid analgesic, antipyretic and antirheumatic, sequela
T40.0X1A - T44.2X5S Poisoning by opium, accidental (unintentional), initial encounter - Adverse effect of ganglionic blocking drugs, sequela
T44.3X5A - T50.Z95S Adverse effect of other parasympatholytics [anticholinergics and antimuscarinics] and spasmolytics, initial encounter - Adverse effect of other vaccines and biological substances, sequela
T50.905A Adverse effect of unspecified drugs, medicaments and biological substances, initial encounter
T50.995A Adverse effect of other drugs, medicaments and biological substances, initial encounter
T63.421A Toxic effect of venom of ants, accidental (unintentional), initial encounter
T63.422A Toxic effect of venom of ants, intentional self-harm, initial encounter
T63.423A Toxic effect of venom of ants, assault, initial encounter
T63.424A Toxic effect of venom of ants, undetermined, initial encounter
T63.441A Toxic effect of venom of bees, accidental (unintentional), initial encounter
T63.442A Toxic effect of venom of bees, intentional self-harm, initial encounter
T63.443A Toxic effect of venom of bees, assault, initial encounter
T63.444A Toxic effect of venom of bees, undetermined, initial encounter
T63.451A Toxic effect of venom of hornets, accidental (unintentional), initial encounter
T63.452A Toxic effect of venom of hornets, intentional self-harm, initial encounter
T63.453A Toxic effect of venom of hornets, assault, initial encounter
T63.454A Toxic effect of venom of hornets, undetermined, initial encounter
T63.461A Toxic effect of venom of wasps, accidental (unintentional), initial encounter
T63.462A Toxic effect of venom of wasps, intentional self-harm, initial encounter
T63.463A Toxic effect of venom of wasps, assault, initial encounter
T63.464A Toxic effect of venom of wasps, undetermined, initial encounter
T65.811A Toxic effect of latex, accidental (unintentional), initial encounter
T65.812A Toxic effect of latex, intentional self-harm, initial encounter
T65.813A Toxic effect of latex, assault, initial encounter
T65.814A Toxic effect of latex, undetermined, initial encounter
T65.894A Toxic effect of other specified substances, undetermined, initial encounter
T78.00XA Anaphylactic reaction due to unspecified food, initial encounter
T78.01XA Anaphylactic reaction due to peanuts, initial encounter
T78.02XA Anaphylactic reaction due to shellfish (crustaceans), initial encounter
T78.03XA Anaphylactic reaction due to other fish, initial encounter
T78.04XA Anaphylactic reaction due to fruits and vegetables, initial encounter
T78.05XA Anaphylactic reaction due to tree nuts and seeds, initial encounter
T78.06XA Anaphylactic reaction due to food additives, initial encounter
T78.07XA Anaphylactic reaction due to milk and dairy products, initial encounter
T78.08XA Anaphylactic reaction due to eggs, initial encounter
T78.09XA Anaphylactic reaction due to other food products, initial encounter
T78.1XXA Other adverse food reactions, not elsewhere classified, initial encounter
T78.2XXA Anaphylactic shock, unspecified, initial encounter
T78.3XXA Angioneurotic edema, initial encounter
T78.40XA Allergy, unspecified, initial encounter
T78.49XA Other allergy, initial encounter
T80.51XA Anaphylactic reaction due to administration of blood and blood products, initial encounter
T80.52XA Anaphylactic reaction due to vaccination, initial encounter
T80.59XA Anaphylactic reaction due to other serum, initial encounter
T80.61XA Other serum reaction due to administration of blood and blood products, initial encounter
T80.62XA Other serum reaction due to vaccination, initial encounter
T80.69XA Other serum reaction due to other serum, initial encounter
T88.6XXA Anaphylactic reaction due to adverse effect of correct drug or medicament properly administered, initial encounter
Z88.0 Allergy status to penicillin
Z88.1 Allergy status to other antibiotic agents
Z88.2 Allergy status to sulfonamides
Z88.3 Allergy status to other anti-infective agents
Z88.4 Allergy status to anesthetic agent
Z88.5 Allergy status to narcotic agent
Z88.6 Allergy status to analgesic agent
Z88.7 Allergy status to serum and vaccine
Z88.8 Allergy status to other drugs, medicaments and biological substances
Z91.010 Allergy to peanuts
Z91.011 Allergy to milk products
Z91.012 Allergy to eggs
Z91.013 Allergy to seafood
Z91.014 Allergy to mammalian meats
Z91.018 Allergy to other foods
Z91.02 Food additives allergy status
Z91.030 Bee allergy status
Z91.038 Other insect allergy status
Z91.040 Latex allergy status
Z91.041 Radiographic dye allergy status
Z91.048 Other nonmedicinal substance allergy status
Z91.09 Other allergy status, other than to drugs and biological substances

Group 2

(3,264 Codes)
Group 2 Paragraph

Specific IgE in Vitro Test 86003, 86008

For codes in the table below that requires a 7th character: letter A initial encounter, D subsequent encounter or S sequela may be used.

Group 2 Codes
Code Description
B44.81 Allergic bronchopulmonary aspergillosis
H10.11 Acute atopic conjunctivitis, right eye
H10.12 Acute atopic conjunctivitis, left eye
H10.13 Acute atopic conjunctivitis, bilateral
H10.31 Unspecified acute conjunctivitis, right eye
H10.32 Unspecified acute conjunctivitis, left eye
H10.33 Unspecified acute conjunctivitis, bilateral
H10.411 Chronic giant papillary conjunctivitis, right eye
H10.412 Chronic giant papillary conjunctivitis, left eye
H10.413 Chronic giant papillary conjunctivitis, bilateral
H10.44 Vernal conjunctivitis
H10.45 Other chronic allergic conjunctivitis
H16.261 Vernal keratoconjunctivitis, with limbar and corneal involvement, right eye
H16.262 Vernal keratoconjunctivitis, with limbar and corneal involvement, left eye
H16.263 Vernal keratoconjunctivitis, with limbar and corneal involvement, bilateral
H65.01 Acute serous otitis media, right ear
H65.02 Acute serous otitis media, left ear
H65.03 Acute serous otitis media, bilateral
H65.04 Acute serous otitis media, recurrent, right ear
H65.05 Acute serous otitis media, recurrent, left ear
H65.06 Acute serous otitis media, recurrent, bilateral
H65.21 Chronic serous otitis media, right ear
H65.22 Chronic serous otitis media, left ear
H65.23 Chronic serous otitis media, bilateral
H65.411 Chronic allergic otitis media, right ear
H65.412 Chronic allergic otitis media, left ear
H65.413 Chronic allergic otitis media, bilateral
H65.491 Other chronic nonsuppurative otitis media, right ear
H65.492 Other chronic nonsuppurative otitis media, left ear
H65.493 Other chronic nonsuppurative otitis media, bilateral
H66.91 Otitis media, unspecified, right ear
H66.92 Otitis media, unspecified, left ear
H66.93 Otitis media, unspecified, bilateral
H68.011 Acute Eustachian salpingitis, right ear
H68.012 Acute Eustachian salpingitis, left ear
H68.013 Acute Eustachian salpingitis, bilateral
H68.021 Chronic Eustachian salpingitis, right ear
H68.022 Chronic Eustachian salpingitis, left ear
H68.023 Chronic Eustachian salpingitis, bilateral
J01.00 Acute maxillary sinusitis, unspecified
J01.01 Acute recurrent maxillary sinusitis
J01.10 Acute frontal sinusitis, unspecified
J01.11 Acute recurrent frontal sinusitis
J01.20 Acute ethmoidal sinusitis, unspecified
J01.21 Acute recurrent ethmoidal sinusitis
J01.30 Acute sphenoidal sinusitis, unspecified
J01.31 Acute recurrent sphenoidal sinusitis
J01.40 Acute pansinusitis, unspecified
J01.41 Acute recurrent pansinusitis
J01.80 Other acute sinusitis
J01.81 Other acute recurrent sinusitis
J01.90 Acute sinusitis, unspecified
J01.91 Acute recurrent sinusitis, unspecified
J04.0 Acute laryngitis
J04.30 Supraglottitis, unspecified, without obstruction
J04.31 Supraglottitis, unspecified, with obstruction
J05.0 Acute obstructive laryngitis [croup]
J30.0 Vasomotor rhinitis
J30.1 Allergic rhinitis due to pollen
J30.2 Other seasonal allergic rhinitis
J30.5 Allergic rhinitis due to food
J30.81 Allergic rhinitis due to animal (cat) (dog) hair and dander
J30.89 Other allergic rhinitis
J31.0 Chronic rhinitis
J31.1 Chronic nasopharyngitis
J31.2 Chronic pharyngitis
J32.0 Chronic maxillary sinusitis
J32.1 Chronic frontal sinusitis
J32.2 Chronic ethmoidal sinusitis
J32.3 Chronic sphenoidal sinusitis
J33.0 Polyp of nasal cavity
J33.8 Other polyp of sinus
J34.3 Hypertrophy of nasal turbinates
J34.81 Nasal mucositis (ulcerative)
J34.89 Other specified disorders of nose and nasal sinuses
J35.01 Chronic tonsillitis
J35.02 Chronic adenoiditis
J35.03 Chronic tonsillitis and adenoiditis
J35.1 Hypertrophy of tonsils
J35.2 Hypertrophy of adenoids
J35.3 Hypertrophy of tonsils with hypertrophy of adenoids
J45.20 Mild intermittent asthma, uncomplicated
J45.21 Mild intermittent asthma with (acute) exacerbation
J45.22 Mild intermittent asthma with status asthmaticus
J45.30 Mild persistent asthma, uncomplicated
J45.31 Mild persistent asthma with (acute) exacerbation
J45.32 Mild persistent asthma with status asthmaticus
J45.40 Moderate persistent asthma, uncomplicated
J45.41 Moderate persistent asthma with (acute) exacerbation
J45.42 Moderate persistent asthma with status asthmaticus
J45.50 Severe persistent asthma, uncomplicated
J45.51 Severe persistent asthma with (acute) exacerbation
J45.52 Severe persistent asthma with status asthmaticus
J45.901 Unspecified asthma with (acute) exacerbation
J45.902 Unspecified asthma with status asthmaticus
J45.991 Cough variant asthma
J45.998 Other asthma
K29.30 Chronic superficial gastritis without bleeding
K29.60 Other gastritis without bleeding
L20.0 Besnier's prurigo
L20.81 Atopic neurodermatitis
L20.82 Flexural eczema
L20.84 Intrinsic (allergic) eczema
L20.89 Other atopic dermatitis
L23.9 Allergic contact dermatitis, unspecified cause
L24.9 Irritant contact dermatitis, unspecified cause
L25.9 Unspecified contact dermatitis, unspecified cause
L27.0 Generalized skin eruption due to drugs and medicaments taken internally
L27.1 Localized skin eruption due to drugs and medicaments taken internally
L27.2 Dermatitis due to ingested food
L27.8 Dermatitis due to other substances taken internally
L27.9 Dermatitis due to unspecified substance taken internally
L29.9 Pruritus, unspecified
L30.0 Nummular dermatitis
L30.2 Cutaneous autosensitization
L30.8 Other specified dermatitis
L50.0 Allergic urticaria
L50.1 Idiopathic urticaria
L50.3 Dermatographic urticaria
L50.6 Contact urticaria
L50.8 Other urticaria
R05.1 Acute cough
R05.2 Subacute cough
R05.3 Chronic cough
R05.4 Cough syncope
R05.8 Other specified cough
R06.02 Shortness of breath
R06.03 Acute respiratory distress
R06.09 Other forms of dyspnea
R06.2 Wheezing
R09.81 Nasal congestion
R21 Rash and other nonspecific skin eruption
R43.0 Anosmia
R43.1 Parosmia
R43.2 Parageusia
R43.8 Other disturbances of smell and taste
T36.0X5A - T39.96XS Adverse effect of penicillins, initial encounter - Underdosing of unspecified nonopioid analgesic, antipyretic and antirheumatic, sequela
T40.0X1A - T44.2X5S Poisoning by opium, accidental (unintentional), initial encounter - Adverse effect of ganglionic blocking drugs, sequela
T44.3X5A - T50.Z95S Adverse effect of other parasympatholytics [anticholinergics and antimuscarinics] and spasmolytics, initial encounter - Adverse effect of other vaccines and biological substances, sequela
T50.905A Adverse effect of unspecified drugs, medicaments and biological substances, initial encounter
T50.995A Adverse effect of other drugs, medicaments and biological substances, initial encounter
T63.421A Toxic effect of venom of ants, accidental (unintentional), initial encounter
T63.422A Toxic effect of venom of ants, intentional self-harm, initial encounter
T63.423A Toxic effect of venom of ants, assault, initial encounter
T63.424A Toxic effect of venom of ants, undetermined, initial encounter
T63.441A Toxic effect of venom of bees, accidental (unintentional), initial encounter
T63.442A Toxic effect of venom of bees, intentional self-harm, initial encounter
T63.443A Toxic effect of venom of bees, assault, initial encounter
T63.444A Toxic effect of venom of bees, undetermined, initial encounter
T63.451A Toxic effect of venom of hornets, accidental (unintentional), initial encounter
T63.452A Toxic effect of venom of hornets, intentional self-harm, initial encounter
T63.453A Toxic effect of venom of hornets, assault, initial encounter
T63.454A Toxic effect of venom of hornets, undetermined, initial encounter
T63.461A Toxic effect of venom of wasps, accidental (unintentional), initial encounter
T63.462A Toxic effect of venom of wasps, intentional self-harm, initial encounter
T63.463A Toxic effect of venom of wasps, assault, initial encounter
T63.464A Toxic effect of venom of wasps, undetermined, initial encounter
T65.811A Toxic effect of latex, accidental (unintentional), initial encounter
T65.812A Toxic effect of latex, intentional self-harm, initial encounter
T65.813A Toxic effect of latex, assault, initial encounter
T65.814A Toxic effect of latex, undetermined, initial encounter
T65.894A Toxic effect of other specified substances, undetermined, initial encounter
T78.00XA Anaphylactic reaction due to unspecified food, initial encounter
T78.01XA Anaphylactic reaction due to peanuts, initial encounter
T78.02XA Anaphylactic reaction due to shellfish (crustaceans), initial encounter
T78.03XA Anaphylactic reaction due to other fish, initial encounter
T78.04XA Anaphylactic reaction due to fruits and vegetables, initial encounter
T78.05XA Anaphylactic reaction due to tree nuts and seeds, initial encounter
T78.06XA Anaphylactic reaction due to food additives, initial encounter
T78.07XA Anaphylactic reaction due to milk and dairy products, initial encounter
T78.08XA Anaphylactic reaction due to eggs, initial encounter
T78.09XA Anaphylactic reaction due to other food products, initial encounter
T78.1XXA Other adverse food reactions, not elsewhere classified, initial encounter
T78.2XXA Anaphylactic shock, unspecified, initial encounter
T78.3XXA Angioneurotic edema, initial encounter
T78.40XA Allergy, unspecified, initial encounter
T78.49XA Other allergy, initial encounter
T80.51XA Anaphylactic reaction due to administration of blood and blood products, initial encounter
T80.52XA Anaphylactic reaction due to vaccination, initial encounter
T80.59XA Anaphylactic reaction due to other serum, initial encounter
T80.61XA Other serum reaction due to administration of blood and blood products, initial encounter
T80.62XA Other serum reaction due to vaccination, initial encounter
T80.69XA Other serum reaction due to other serum, initial encounter
T88.6XXA Anaphylactic reaction due to adverse effect of correct drug or medicament properly administered, initial encounter
Z88.0 Allergy status to penicillin
Z88.1 Allergy status to other antibiotic agents
Z88.2 Allergy status to sulfonamides
Z88.3 Allergy status to other anti-infective agents
Z88.4 Allergy status to anesthetic agent
Z88.5 Allergy status to narcotic agent
Z88.6 Allergy status to analgesic agent
Z88.7 Allergy status to serum and vaccine
Z88.8 Allergy status to other drugs, medicaments and biological substances
Z91.010 Allergy to peanuts
Z91.011 Allergy to milk products
Z91.012 Allergy to eggs
Z91.013 Allergy to seafood
Z91.014 Allergy to mammalian meats
Z91.018 Allergy to other foods
Z91.048 Other nonmedicinal substance allergy status
Z91.09 Other allergy status, other than to drugs and biological substances

Group 3

(57 Codes)
Group 3 Paragraph

Food allergy testing 95004
Medicare is establishing the following limited coverage for food allergies.

For codes in the table below that requires a 7th character: letter A initial encounter, D subsequent encounter or S sequela may be used.

Group 3 Codes
Code Description
K20.0 Eosinophilic esophagitis
K52.21 Food protein-induced enterocolitis syndrome
K52.22 Food protein-induced enteropathy
K52.29 Other allergic and dietetic gastroenteritis and colitis
K52.3 Indeterminate colitis
K52.831 Collagenous colitis
K52.832 Lymphocytic colitis
K52.838 Other microscopic colitis
K52.89 Other specified noninfective gastroenteritis and colitis
R05.1 Acute cough
R05.2 Subacute cough
R05.3 Chronic cough
R05.4 Cough syncope
R05.8 Other specified cough
R06.02 Shortness of breath
R06.03 Acute respiratory distress
R06.2 Wheezing
R11.0 Nausea
R11.10 Vomiting, unspecified
R11.11 Vomiting without nausea
R11.12 Projectile vomiting
R11.2 Nausea with vomiting, unspecified
R14.0 Abdominal distension (gaseous)
R14.1 Gas pain
R14.2 Eructation
R14.3 Flatulence
R19.7 Diarrhea, unspecified
T78.00XA Anaphylactic reaction due to unspecified food, initial encounter
T78.00XD Anaphylactic reaction due to unspecified food, subsequent encounter
T78.00XS Anaphylactic reaction due to unspecified food, sequela
T78.01XA Anaphylactic reaction due to peanuts, initial encounter
T78.01XD Anaphylactic reaction due to peanuts, subsequent encounter
T78.01XS Anaphylactic reaction due to peanuts, sequela
T78.02XA Anaphylactic reaction due to shellfish (crustaceans), initial encounter
T78.02XD Anaphylactic reaction due to shellfish (crustaceans), subsequent encounter
T78.02XS Anaphylactic reaction due to shellfish (crustaceans), sequela
T78.03XA Anaphylactic reaction due to other fish, initial encounter
T78.03XD Anaphylactic reaction due to other fish, subsequent encounter
T78.03XS Anaphylactic reaction due to other fish, sequela
T78.04XA Anaphylactic reaction due to fruits and vegetables, initial encounter
T78.04XD Anaphylactic reaction due to fruits and vegetables, subsequent encounter
T78.04XS Anaphylactic reaction due to fruits and vegetables, sequela
T78.05XA Anaphylactic reaction due to tree nuts and seeds, initial encounter
T78.05XD Anaphylactic reaction due to tree nuts and seeds, subsequent encounter
T78.05XS Anaphylactic reaction due to tree nuts and seeds, sequela
T78.06XA Anaphylactic reaction due to food additives, initial encounter
T78.06XD Anaphylactic reaction due to food additives, subsequent encounter
T78.06XS Anaphylactic reaction due to food additives, sequela
T78.07XA Anaphylactic reaction due to milk and dairy products, initial encounter
T78.07XD Anaphylactic reaction due to milk and dairy products, subsequent encounter
T78.07XS Anaphylactic reaction due to milk and dairy products, sequela
T78.08XA Anaphylactic reaction due to eggs, initial encounter
T78.08XD Anaphylactic reaction due to eggs, subsequent encounter
T78.08XS Anaphylactic reaction due to eggs, sequela
T78.09XA Anaphylactic reaction due to other food products, initial encounter
T78.09XD Anaphylactic reaction due to other food products, subsequent encounter
T78.09XS Anaphylactic reaction due to other food products, sequela

Group 4

(34 Codes)
Group 4 Paragraph

Patch Tests 95044, 95052

Group 4 Codes
Code Description
L23.0 Allergic contact dermatitis due to metals
L23.1 Allergic contact dermatitis due to adhesives
L23.2 Allergic contact dermatitis due to cosmetics
L23.3 Allergic contact dermatitis due to drugs in contact with skin
L23.4 Allergic contact dermatitis due to dyes
L23.5 Allergic contact dermatitis due to other chemical products
L23.6 Allergic contact dermatitis due to food in contact with the skin
L23.7 Allergic contact dermatitis due to plants, except food
L23.81 Allergic contact dermatitis due to animal (cat) (dog) dander
L23.89 Allergic contact dermatitis due to other agents
L23.9 Allergic contact dermatitis, unspecified cause
L24.0 Irritant contact dermatitis due to detergents
L24.1 Irritant contact dermatitis due to oils and greases
L24.2 Irritant contact dermatitis due to solvents
L24.3 Irritant contact dermatitis due to cosmetics
L24.4 Irritant contact dermatitis due to drugs in contact with skin
L24.5 Irritant contact dermatitis due to other chemical products
L24.6 Irritant contact dermatitis due to food in contact with skin
L24.7 Irritant contact dermatitis due to plants, except food
L24.81 Irritant contact dermatitis due to metals
L24.89 Irritant contact dermatitis due to other agents
L24.9 Irritant contact dermatitis, unspecified cause
L25.0 Unspecified contact dermatitis due to cosmetics
L25.1 Unspecified contact dermatitis due to drugs in contact with skin
L25.2 Unspecified contact dermatitis due to dyes
L25.3 Unspecified contact dermatitis due to other chemical products
L25.4 Unspecified contact dermatitis due to food in contact with skin
L25.5 Unspecified contact dermatitis due to plants, except food
L25.8 Unspecified contact dermatitis due to other agents
L30.0 Nummular dermatitis
L30.2 Cutaneous autosensitization
L30.8 Other specified dermatitis
T84.89XS Other specified complication of internal orthopedic prosthetic devices, implants and grafts, sequela
Z91.09 Other allergy status, other than to drugs and biological substances

Group 5

(47 Codes)
Group 5 Paragraph

Ingestion Challenge Testing 95076, 95079

For codes in the table below that requires a 7th character: letter A initial encounter, D subsequent encounter or S sequela may be used.

Group 5 Codes
Code Description
L27.2 Dermatitis due to ingested food
T78.00XA Anaphylactic reaction due to unspecified food, initial encounter
T78.00XD Anaphylactic reaction due to unspecified food, subsequent encounter
T78.00XS Anaphylactic reaction due to unspecified food, sequela
T78.01XA Anaphylactic reaction due to peanuts, initial encounter
T78.01XD Anaphylactic reaction due to peanuts, subsequent encounter
T78.01XS Anaphylactic reaction due to peanuts, sequela
T78.02XA Anaphylactic reaction due to shellfish (crustaceans), initial encounter
T78.02XD Anaphylactic reaction due to shellfish (crustaceans), subsequent encounter
T78.02XS Anaphylactic reaction due to shellfish (crustaceans), sequela
T78.03XA Anaphylactic reaction due to other fish, initial encounter
T78.03XD Anaphylactic reaction due to other fish, subsequent encounter
T78.03XS Anaphylactic reaction due to other fish, sequela
T78.04XA Anaphylactic reaction due to fruits and vegetables, initial encounter
T78.04XD Anaphylactic reaction due to fruits and vegetables, subsequent encounter
T78.04XS Anaphylactic reaction due to fruits and vegetables, sequela
T78.05XA Anaphylactic reaction due to tree nuts and seeds, initial encounter
T78.05XD Anaphylactic reaction due to tree nuts and seeds, subsequent encounter
T78.05XS Anaphylactic reaction due to tree nuts and seeds, sequela
T78.06XA Anaphylactic reaction due to food additives, initial encounter
T78.06XD Anaphylactic reaction due to food additives, subsequent encounter
T78.06XS Anaphylactic reaction due to food additives, sequela
T78.07XA Anaphylactic reaction due to milk and dairy products, initial encounter
T78.07XD Anaphylactic reaction due to milk and dairy products, subsequent encounter
T78.07XS Anaphylactic reaction due to milk and dairy products, sequela
T78.08XA Anaphylactic reaction due to eggs, initial encounter
T78.08XD Anaphylactic reaction due to eggs, subsequent encounter
T78.08XS Anaphylactic reaction due to eggs, sequela
T78.09XA Anaphylactic reaction due to other food products, initial encounter
T78.09XD Anaphylactic reaction due to other food products, subsequent encounter
T78.09XS Anaphylactic reaction due to other food products, sequela
Z88.0 Allergy status to penicillin
Z88.1 Allergy status to other antibiotic agents
Z88.2 Allergy status to sulfonamides
Z88.3 Allergy status to other anti-infective agents
Z88.4 Allergy status to anesthetic agent
Z88.5 Allergy status to narcotic agent
Z88.6 Allergy status to analgesic agent
Z88.7 Allergy status to serum and vaccine
Z88.8 Allergy status to other drugs, medicaments and biological substances
Z91.010 Allergy to peanuts
Z91.011 Allergy to milk products
Z91.012 Allergy to eggs
Z91.013 Allergy to seafood
Z91.014 Allergy to mammalian meats
Z91.018 Allergy to other foods
Z91.02 Food additives allergy status
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ICD-10-CM Codes that DO NOT Support Medical Necessity

Group 1

Group 1 Paragraph

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Group 1 Codes

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ICD-10-PCS Codes

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

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Additional ICD-10 Information

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Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

Code Description
N/A

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

Code Description
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Other Coding Information

Group 1

Group 1 Paragraph

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Group 1 Codes

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Coding Table Information

Excluded CPT/HCPCS Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
N/A N/A
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Non-Excluded CPT/HCPCS Ended Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
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Revision History Information

Revision History Date Revision History Number Revision History Explanation
10/01/2022 R6

Posted 09/29/2022 Under ICD-10-CM Codes that Support Medical Necessity Group 1 & 2 Codes the following codes were added: T43.651A, T43.651D, T43.651S, T43.652A, T43.652D, T43.652S, T43.653A, T43.653D, T43.653S, T43.654A, T43.654D, T43.654S, T43.655A, T43.655D, T43.655S, T43.656A, T43.656D, and T43.656S. These updates were made due to the annual ICD-10-CM code update and are effective 10/01/2022. Review completed 09/07/2022.

08/11/2022 R5

08/11/2022 Under Billing Guidelines the following statement was removed “Histamine and saline controls are appropriate and can be billed as two antigens.” This statement is incorrect since CMS payment policy does not allow including testing of positive or negative controls in the number of tests reported.

01/01/2022 R4

12/30/2021 CPT/HCPCS 2022 Annual Code Updates: Under CPT/HCPCS Codes Group 1 Paragraph, 95070 had a description change.

10/01/2021 R3

09/30/2021 ICD-10 CM Code Updates: Under ICD-10 Codes that Support Medical Necessity, deleted R05 from Group 1, Group 2, and Group 3 Codes. Added R05.1, R05.2, R05.3, R05.4, and R05.8 to Group 1, Group 2, and Group 3 Codes. Added to Group 1 and Group 2 Codes: T40.711A, T40.711D, T40.711S, T40.712A, T40.712D, T40.712S, T40.713A, T40.713D, T40.713S, T40.714A, T40.714D, T40.714S, T40.715A, T40.715D, T40.715S, T40.716A, T40.716D, T40.716S, T40.721A, T40.721D, T40.721S, T40.722A, T40.722D, T40.722S, T40.723A, T40.723D, T40.723S, T40.724A, T40.724D, T40.724S, T40.725A, T40.725D, T40.725S, T40.726A, T40.726D, and T40.726S. Added Z91.014 to Group 1, Group 2, and Group 5 Codes. Grammar and punctuation corrections made throughout the article. Review completed 08/11/2021.

01/01/2021 R2

CPT/HCPCS Annual Code Update. Deleted: 95071.

10/01/2020 R1

10/01/2020 ICD-10-CM Code Updates to Groups 1, 2, and 5: Description changes for Z88.1, Z88.2, Z88.3, Z88.4, Z88.5, Z88.6, Z88.7, and Z88.8.

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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
SAD Process URL 1
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SAD Process URL 2
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Statutory Requirements URLs
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Rules and Regulations URLs
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CMS Manual Explanations URLs
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Other URLs
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Public Versions
Updated On Effective Dates Status
04/16/2024 04/01/2024 - N/A Currently in Effect View
09/21/2022 10/01/2022 - 03/31/2024 Superseded You are here
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Keywords

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