How To Use CPT Code 95052

CPT 95052 describes the procedure for photo patch tests, which are performed in combination with a patch test to identify specific allergies in patients. 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 95052?

CPT 95052 can be used to describe the procedure for photo patch tests, which are conducted in conjunction with a patch test to determine specific allergies in patients. This code is used when a physician applies a patch containing allergy-causing extracts onto the patient’s arm and exposes it to ultraviolet light. The physician then observes the patient’s skin reaction or anaphylactic reaction to identify specific allergies.

2. Official Description

The official description of CPT code 95052 is: ‘Photo patch test(s) (specify number of tests).’ This code falls under the Medicine section, specifically the Allergy and Clinical Immunology subsection. It is important to note that an allergenic extract, which is a protein purified from a substance that may cause allergies, is used in conjunction with the patch test for photo patch tests.

3. Procedure

1. The physician selects the appropriate allergenic extract(s) based on the suspected allergies of the patient.
2. A patch containing the allergenic extract(s) is applied to the patient’s arm.
3. The patch is exposed to ultraviolet light.
4. The physician carefully observes the patient’s skin reaction or anaphylactic reaction to determine specific allergies.

4. Qualifying circumstances

CPT 95052 is used when a patient undergoes photo patch tests in combination with a patch test to identify specific allergies. These tests are typically performed when a patient exhibits symptoms or has a history of allergic reactions. It is important to note that the physician must directly supervise the procedure in case the patient experiences an anaphylactic reaction.

5. When to use CPT code 95052

CPT code 95052 should be used when a physician performs photo patch tests in conjunction with a patch test to identify specific allergies in a patient. It is important to note that this code should not be used for standalone patch tests or other allergy testing procedures. The use of CPT code 95052 is specific to the combination of photo patch tests and patch tests.

6. Documentation requirements

To support a claim for CPT 95052, the physician must document the following information:

• Specific allergenic extract(s) used for the photo patch tests
• Date and time of the procedure
• Observations of the patient’s skin reaction or anaphylactic reaction
• Any specific allergies identified through the tests
• Physician’s signature

7. Billing guidelines

When billing for CPT 95052, ensure that the procedure is performed under the direct supervision of a physician. It is important to note that CPT code 95052 should not be reported with other codes unless medically necessary. Additionally, it is crucial to follow the guidelines provided by the payer and submit accurate documentation to support the claim.

8. Historical information

CPT 95052 was added to the Current Procedural Terminology system on January 1, 1994. There have been no updates or changes to the code since its addition.

9. Examples

1. A physician performs photo patch tests on a patient suspected of having allergies to various substances, including pollen, dust mites, and pet dander.
2. A patient with a history of skin reactions undergoes photo patch tests to identify specific allergies to certain chemicals used in cosmetics.
3. A physician conducts photo patch tests on a patient with suspected allergies to common food allergens, such as peanuts, eggs, and milk.
4. A patient presents with symptoms of allergic rhinitis, and the physician performs photo patch tests to determine specific allergens causing the symptoms.
5. A physician administers photo patch tests to a patient with suspected contact dermatitis to identify the specific substances triggering the skin reaction.
6. A patient with a history of anaphylactic reactions undergoes photo patch tests to identify the specific allergens responsible for the severe allergic responses.
7. A physician performs photo patch tests on a patient with suspected allergies to various environmental allergens, such as grass, mold, and tree pollen.
8. A patient with recurring hives undergoes photo patch tests to identify the specific triggers causing the allergic reactions.
9. A physician conducts photo patch tests on a patient with suspected allergies to certain medications to determine the specific drug allergens.
10. A patient with a history of allergic reactions to insect bites undergoes photo patch tests to identify the specific insect allergens causing the reactions.