CPT Code 95004: Percutaneous Allergy Skin Testing (Prick/Puncture)

For 95004 Medicare billing, providers must ensure the service meets medical necessity and is supported by appropriate ICD-10-CM codes. Documentation must specify the number of tests performed, and each test must be individually reported. Additionally, Medicare may have limits on how many tests are reimbursable per session, so it’s essential to consult the payer's policy to determine allowable units.

Yes. CPT code 95004 includes prick with allergenic extracts and puncture prick with allergenic extracts, commonly used for percutaneous allergy testing. These methods introduce allergens into the skin to observe for immediate type reactions, and the procedure typically includes the use of positive or negative controls.

You can find billing and coding guidance for CPT 95004 through local Medicare contractors, national payer websites, and professional organizations like the American Medical Association. Proper documentation must include test interpretation and report, the number of tests, and adherence to payer-specific fee schedules.