How To Use CPT Code 95017

CPT 95017 describes the procedure for allergy testing, which involves a combination of percutaneous and intracutaneous tests to determine immediate type reactions to venoms. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 95017?

CPT 95017 can be used to describe the procedure for allergy testing, specifically for immediate type reactions to venoms. This code encompasses a combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal) tests, which are performed sequentially and incrementally. The purpose of the test is to identify specific allergens that may be causing allergic reactions in patients.

2. Official Description

The official description of CPT code 95017 is: ‘Allergy testing, any combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal), sequential and incremental, with venoms, immediate type reaction, including test interpretation and report, specify number of tests.’

3. Procedure

1. The allergy testing procedure involves two types of tests: percutaneous and intracutaneous.
2. Percutaneous test: A drop of solution containing a potential allergen (venom) is placed on the skin, followed by a series of scratches or pricks using a needle. This allows the solution to enter the skin and elicit a reaction if the patient is allergic to the specific allergen.
3. Intracutaneous test: If a substance does not cause a reaction in the percutaneous test but is still suspected as an allergen (venom), an intradermal test is performed. A small amount of the allergen solution is injected into the deeper layers of the skin to observe if an allergic response occurs.

4. Qualifying circumstances

CPT 95017 is applicable to patients who require allergy testing for immediate type reactions to venoms. This may include individuals who have experienced allergic reactions to insect stings or bites. The test should be performed by a qualified healthcare professional who can interpret and report the results accurately. It is important to specify the number of tests conducted during the procedure.

5. When to use CPT code 95017

CPT code 95017 should be used when conducting allergy testing for immediate type reactions to venoms. It is important to ensure that the procedure involves a combination of percutaneous and intracutaneous tests, performed sequentially and incrementally. This code should be used when reporting the test interpretation and report as well.

6. Documentation requirements

To support a claim for CPT 95017, the healthcare professional must document the following information:

• Patient’s symptoms or history of allergic reactions
• Specific allergens tested, including venoms
• Number of percutaneous and intracutaneous tests performed
• Results of each test and the overall interpretation
• Any immediate type reactions observed
• Signature of the healthcare professional conducting the test

7. Billing guidelines

When billing for CPT 95017, ensure that the procedure involves a combination of percutaneous and intracutaneous tests for immediate type reactions to venoms. It is important to specify the number of tests conducted. Additionally, consider any specific guidelines provided by insurance companies or payers regarding the reporting of allergy testing procedures.

8. Historical information

CPT 95017 was added to the Current Procedural Terminology system on January 1, 2013. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with a history of severe allergic reactions to bee stings undergoes allergy testing to determine the specific venom causing the reactions.
2. An individual who frequently experiences hives after consuming certain foods undergoes allergy testing to identify the specific allergens responsible.
3. A patient with suspected allergies to multiple environmental factors undergoes allergy testing to pinpoint the specific triggers.
4. An individual with a history of allergic reactions to medications undergoes allergy testing to identify the specific drug allergens.
5. A patient with suspected allergies to various types of pollen undergoes allergy testing to determine the specific allergens causing symptoms.
6. An individual who frequently experiences respiratory symptoms in certain environments undergoes allergy testing to identify the specific allergens present.
7. A patient with a history of allergic reactions to latex undergoes allergy testing to confirm the allergy and identify other potential cross-reactive allergens.
8. An individual with suspected allergies to specific animal dander undergoes allergy testing to determine the specific allergens causing symptoms.
9. A patient with a history of allergic reactions to dust mites undergoes allergy testing to identify the specific allergens present in their environment.
10. An individual with suspected allergies to certain molds undergoes allergy testing to determine the specific allergens causing symptoms.