CPT Code Lookup Tool
Use this free CPT Lookup Tool to search for Current Procedural Terminology (CPT) codes, descriptions, and related details — designed to help streamline and simplify your medical billing process.
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Office or other outpatient visit
Evaluation and management of an established patient...
Information
This code is for use in medical billing and coding.
Information
This code is part of the section of CPT codes.
Office or other outpatient visit for the evaluation and management...
Note
This description reflects the 2021 E/M coding guidelines.
Information
codes are used to report evaluation and management services provided in various settings.
Information
RVUs are used to determine the fee for a service under the Medicare Physician Fee Schedule.
Information
This code is commonly used by primary care providers, but may be used by any specialty providing office visits.
Significant, separately identifiable E/M service
Information
Modifiers provide additional information about the service provided.
Detail About CPT 95004
Related Codes Table
| CPT Code | Description |
|---|---|
| 95024 | Patch or application test(s) (specify number of tests) |
| 95027 | Intracutaneous (intradermal) tests with allergenic extracts; immediate type reaction, including test interpretation and report by a physician |
| 95044 | Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction, including test interpretation and report by a physician |
| 95056 | Patch or application test(s) (specify number of tests); photopatch, additional readings |
| 95060 | Patch or application test(s) (specify number of tests); delayed reading through 72 hours |
Commonly Billed With
CPT code 95004 is commonly billed with evaluation and management codes such as 99213 for office visits related to allergy testing.
Clinical Scenarios
Allergy Testing for Suspected Food Allergies:
A patient presents with symptoms suggestive of food allergies. CPT code 95004 may be used to perform percutaneous tests with allergenic extracts to identify specific food allergens.
Seasonal Allergy Evaluation:
During the spring season, a patient experiences recurrent allergic rhinitis symptoms. CPT code 95004 can be utilized to conduct percutaneous tests with allergenic extracts to determine the allergens triggering the symptoms.
Allergy Testing for Insect Sting Allergies:
A patient reports a history of severe reactions to insect stings. CPT code 95004 may be employed to perform percutaneous tests with allergenic extracts to assess sensitivity to insect venom.
FAQ
Can CPT code 95004 be used for skin testing in children?
Yes, CPT code 95004 can be utilized for skin testing in pediatric patients.
Are there any specific documentation requirements for reporting CPT code 95004?
Providers must document the specific allergens tested and any observed reactions for accurate reporting of CPT code 95004.
Is prior authorization required for CPT code 95004?
Prior authorization policies vary among payers, so it is advisable to check with the insurance carrier before performing the procedure.
Can CPT code 95004 be reported alongside other allergy testing procedures?
Yes, CPT code 95004 can be billed in conjunction with other allergy testing procedures as long as they are medically necessary and distinct services.
What is the typical reimbursement rate for CPT code 95004?
The reimbursement rate for CPT code 95004 varies based on factors such as location, payer policies, and individual provider contracts.
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