Z01.82 — Encounter for allergy testing
ICD-10-CM
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Documentation Required
- The patient's medical record must include the ordering provider's assessment related to the patient's complaint for that visit.
- The medical record must include relevant medical history and results of pertinent tests and procedures.
- Office visit records and operative reports must be signed and dated; all services ordered or rendered to Medicare beneficiaries must be signed.
- When using the -GA modifier and ABN, Form CMS-R-131 must be signed by the beneficiary (or properly witnessed if the beneficiary refuses to sign) to indicate acceptance of payment responsibility.
Key Coverage Criteria
- For services that require a referring or ordering physician, the claim must report the referring/ordering physician's name and NPI.
- Claims must include a valid ICD-10-CM diagnosis code that best describes the patient's condition for which the service was performed; otherwise the claim will be returned as incomplete under SSA Section 1833(e).
- For diagnostic tests, the claim should report the test result if known, otherwise report the symptoms that prompted the test.
- If a service is likely to be non-covered, an Advance Beneficiary Notice (ABN) may be used and the appropriate modifier (GA, GX, GY, or GZ) should be appended to the claim as applicable.
- CPT code 93355 is used to report transesophageal echocardiography (TEE) performed during transcatheter intracardiac therapies.
- When contrast is used for a complete TEE procedure (probe placement, image acquisition, interpretation and report), bill CPT code 93312 (HCPCS C8925 for OPPS billing).
9 Active Policies
L35016 — Transesophageal Echocardiography (TEE)
J12
A56505 — Billing and Coding: Transesophageal Echocardiography (TEE)
J12
A56809 — Billing and Coding: Transesophageal Echocardiography (TEE)
A57306 — Billing and Coding: Transthoracic Echocardiography (TTE)
L34337 — Transesophageal Echocardiography (TEE)
Related Codes
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