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Correct billing for CPT® 95004
Is this code billed by antigen or by the number of skin pricks?
re: CORRECT BILLING FOR CPT® 95004
Interpretation of CPT® codes: 95004 - 95052; use the code number which includes the number of tests which were performed and enter 1 unit for each test performed. For example, if 18 scratch tests are done, code 95004 with 18 like services. If 36 are done, code 95004 with 36 like services. If a physician performs 25 percutaneous tests (scratch, puncture, or prick) with allergenic extract, the physician must bill code 95004 and specify 25 in the units field of Form CMS-1500 (paper claims or electronic format). To compute payment, the Medicare carrier multiplies the payment for one test (i.e., the payment listed in the fee schedule) by the quantity listed in the units field.