How To Use CPT Code 95056

CPT code 95056 describes the procedure for photo tests in the field of allergy and clinical immunology. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 95056?

CPT 95056 can be used to describe the procedure for photo tests, which are performed to determine allergies that occur when exposed to sunlight. This code is used when a physician exposes the patient’s skin to ultraviolet light and notes the skin’s reaction or anaphylactic reaction to uncover specific allergies.

2. Official Description

The official description of CPT code 95056 is: ‘An allergenic extract is a protein containing an extract purified from a substance to which a patient may be allergic. A photo test may be performed without a patch test; and are useful in determining allergies occurring when exposed to sunlight.’

3. Procedure

1. The physician exposes the patient’s skin to ultraviolet light.
2. The physician observes and notes the skin’s reaction or anaphylactic reaction to determine specific allergies.

4. Qualifying circumstances

Patients eligible to receive CPT 95056 are those who may have allergies to substances that are triggered by exposure to sunlight. The procedure must be performed by a physician and requires direct supervision in case the patient has an anaphylactic reaction to the test.

5. When to use CPT code 95056

CPT code 95056 should be used when a photo test is performed to determine allergies occurring when exposed to sunlight. It should not be used for other types of allergy testing procedures.

6. Documentation requirements

To support a claim for CPT 95056, the physician must document the following information:

• Patient’s specific allergies being tested
• Date and details of the photo test procedure
• Any observed reactions or anaphylactic reactions
• Physician’s signature

7. Billing guidelines

When billing for CPT 95056, ensure that the procedure is performed by a physician and that direct supervision is provided in case of an anaphylactic reaction. There are no specific guidelines regarding reporting CPT 95056 with other codes.

8. Historical information

CPT 95056 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A physician performing a photo test to determine if a patient is allergic to specific substances when exposed to sunlight.
2. A dermatologist conducting a photo test to identify allergies triggered by sunlight in a patient with suspected photosensitivity.
3. An allergist administering a photo test to determine if a patient has allergies to certain substances that are exacerbated by sunlight exposure.
4. A physician conducting a photo test to identify allergies that occur when the patient’s skin is exposed to ultraviolet light.
5. A dermatologist performing a photo test to determine if a patient has allergies to specific substances that are triggered by sunlight exposure.
6. An allergist conducting a photo test to identify allergies that occur when the patient is exposed to sunlight.
7. A physician performing a photo test to determine if a patient has allergies to substances that are exacerbated by sunlight exposure.
8. A dermatologist conducting a photo test to identify allergies that occur when the patient’s skin is exposed to ultraviolet light.
9. An allergist administering a photo test to determine if a patient is allergic to specific substances when exposed to sunlight.
10. A physician conducting a photo test to identify allergies triggered by sunlight in a patient with suspected photosensitivity.