Medicare allergy testing CPT codes

Allergy Testing 

Allergen-specific IgE determinations are coded using the following two codes:

• 86003 ALLERGEN-SPECIFIC IgE: quantitative semiquantitative, each allergen
• 86005 ALLERGEN-SPECIFIC IgE: qualitative, multiallergen screen (dipstick or disk)

CPT code 86003 should be submitted for each allergen determined.
Other allergy testing is described under the Medicine section of the CPT using the following codes (954004-95078). These codes are not part of the laboratory fee schedule and are paid from the Physician Fee Schedule.
scratch, puncture, and prick tests

• 95004 PERCUTANEOUS TESTS: with allergenic extracts, immediate type reaction, specify number of tests
• 95010 PERCUTANEOUS TESTS: sequential and incremental, with drugs, biologicals or venoms, immediate type reaction, specify number of tests

intradermal tests

• 95015 INTRACUTANEOUS TESTS: sequential and incremental, with drugs, biologicals or venoms, immediate type reaction, specify number of tests
• 95024 INTRACUTANEOUS TESTS: with allergenic extracts, immediate type reaction, specify number of tests
• 95028 INTRACUTANEOUS TESTS: with allergenic extracts, delayed type reaction, including reading, specify number of tests

other tests

• 95027 SKIN END POINT
• 95044 PATCH OR APPLICATION TEST(S): specify number of tests
• 95052 PHOTO PATCH TEST(S): specify number of tests
• 95056 PHOTO TESTS
• 95060 OPTHALMIC MUCOUS MEMBRANE TESTS
• 95065 DIRECT NASAL MUCOUS MEMBRANE TEST
• 95070 INHALATION BRONCHIAL CHALLENGE TESTING: with histamine, methacholine, or similar compounds
• 95071 INHALATION BRONCHIAL CHALLENGE TESTING: with antigens or gases, specify
• 95075 INGESTION CHALLENGE TEST
• 85078 PROVOCATIVE TESTING: (for example, Rinkel test)

CPT codes for percutaneous (scratch, puncture, or prick), intracutaneous (intradermal), and patch tests include test performance, evaluation, and correlation with the patient's history, physical examination, and other observations. The number of tests should be dependent upon history, physical findings, and clinical judgment. All patients should not receive the same number or type of sensitivity tests.