Medicare Compliance & Reimbursement - 2020 Issue 1
Reader Question: Don’t Sneeze at This E/M, Allergy Testing Advice
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Article Overview
This article addresses a coding question about evaluation and management reporting in the setting of allergy testing. It explains the general CPT framework for when test-result review is considered part of the testing service and references the relevant allergy testing procedure area, along with the modifier used when a separate service is performed. It is intended for coders, billers, and clinicians working with E/M and allergy testing services.
Why This Topic Matters
Understanding the boundary between bundled test-related work and separately reportable E/M services helps prevent inappropriate claim submissions and supports compliant reporting for allergy testing encounters.
Article Sections
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Question
Introduces a coding scenario involving allergy testing and a request to report an additional service on the same day.
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Answer
Summarizes the general CPT guidance discussed in the article and frames the relationship between allergy testing and a separate E/M service.
What You Will Learn
- How the article frames E/M reporting in relation to allergy testing
- What broad CPT guidance is referenced for reviewing test results
- When the article indicates a separate service may be considered in general terms
- Which coding references are associated with allergy testing procedures and same-day E/M reporting
Who Should Read This
- Medical coders
- Billing staff
- Physicians
- Other qualified health care professionals
- Compliance staff
Code Ranges Discussed
Modifiers Discussed
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