How To Use CPT Code 95018

CPT 95018 describes a type of skin test used to identify substances that trigger immediate allergic responses in individuals. 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 95018?

CPT 95018 can be used to perform allergy testing procedures on patients. This code specifically refers to a combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal) tests. The tests are done sequentially and incrementally, using drugs or biologicals to elicit immediate type reactions. The provider also interprets the test results and prepares a report specifying the number of tests conducted.

2. Official Description

The official description of CPT code 95018 is: ‘Allergy testing, any combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal), sequential and incremental, with drugs or biologicals, immediate type reaction, including test interpretation and report, specify number of tests.’

3. Procedure

1. The percutaneous test involves placing a drop of solution containing a potential allergen on the skin. The provider then performs a series of scratches or pricks using a needle to allow the solution to enter the skin. If a red, raised, and itchy area develops, it indicates an allergic reaction to that allergen.
2. In cases where the percutaneous test does not produce a reaction but there is still suspicion of an allergen, an intracutaneous or intradermal test is performed. This involves injecting a small amount of the allergen solution into the deeper layers of the skin to elicit an allergic response if the person is allergic to that substance.

4. Qualifying circumstances

CPT 95018 is used for patients who require allergy testing to identify substances that trigger immediate allergic reactions. The test can be performed on individuals suspected of having allergies to drugs or biologicals. It is important to note that this code specifically refers to immediate type reactions and does not cover delayed type reactions. The provider must specify the number of tests conducted in the report.

5. When to use CPT code 95018

CPT code 95018 should be used when performing a combination of percutaneous and intracutaneous allergy tests to identify immediate type reactions. It is not appropriate to use this code for delayed type reactions or for other types of allergy testing procedures.

6. Documentation requirements

To support a claim for CPT 95018, the provider must document the following information:

• Patient’s symptoms or suspected allergies
• Specific allergens tested
• Number of percutaneous and intracutaneous tests conducted
• Results of each test
• Interpretation of the test results
• Preparation of a report specifying the number of tests conducted

7. Billing guidelines

When billing for CPT 95018, ensure that the procedure involves a combination of percutaneous and intracutaneous tests for immediate type reactions. It is important to specify the number of tests conducted in the report. This code should not be reported for delayed type reactions or for other types of allergy testing procedures. It is also important to follow any additional guidelines provided by the payer or coding guidelines.

8. Historical information

CPT 95018 was added to the Current Procedural Terminology system on January 1, 2013. There have been no updates to the code since its addition.

9. Examples

1. A patient undergoes percutaneous and intracutaneous allergy testing to identify immediate type reactions to various drugs and biologicals.
2. A provider performs a combination of percutaneous and intracutaneous tests on a patient suspected of having allergies to specific allergens.
3. An individual undergoes allergy testing using a sequential and incremental approach with drugs and biologicals to identify immediate type reactions.
4. A provider conducts percutaneous and intracutaneous tests on a patient to determine immediate type reactions to a range of potential allergens.
5. A patient undergoes allergy testing using a combination of percutaneous and intracutaneous tests to identify immediate type reactions to specific allergens.
6. A provider performs percutaneous and intracutaneous tests on a patient to identify immediate type reactions to drugs and biologicals.
7. An individual undergoes allergy testing using a sequential and incremental approach with drugs and biologicals to identify immediate type reactions to specific allergens.
8. A provider conducts a combination of percutaneous and intracutaneous tests on a patient suspected of having immediate type reactions to certain allergens.
9. A patient undergoes percutaneous and intracutaneous allergy testing to identify immediate type reactions to a range of potential allergens.
10. A provider performs allergy testing using a combination of percutaneous and intracutaneous tests to identify immediate type reactions to drugs and biologicals.