Billing and Coding: Allergy Testing

Allergy skin testing (prick/puncture, intracutaneous, percutaneous, and multitest) is covered when medically necessary for evaluation of inhalant and food allergens, with supportive medical record documentation and ICD-10-CM codes required on each claim. Typical testing ranges are provided (e.g., up to 90 prick tests and up to 40 intracutaneous tests for inhalants; up to 40 percutaneous tests for foods; up to 60 intracutaneous via multitest for selected patients), and tests exceeding professional standards or typical utilization may be denied or selected for medical review unless clinical justification (including failed preliminary testing and failed immunotherapy) is documented.

"Allergy testing for inhalant allergens is covered when medically necessary; evaluation may include up to 90 prick-puncture tests followed by up to 40 intracutaneous tests if prick/puncture results ..."