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Jurisdiction 1 Part B
Updated: Allergy Testing LCD

States Applicable to Alert:
American Samoa, Guam, Hawaii, Nevada, Northern Mariana Islands, Northern California and Southern California
 
Background Information:
Incorrect ICD-9-CM codes were entered into the Palmetto GBA system for some CPT codes listed in the Allergy Testing LCD. As a result, the services may have been underpaid or overpaid since the J1 transition.
 
Applies To Procedure Codes:
Northern and Southern California: CPT code 86003
  • If CPT code 86003 was submitted with ICD-9-CM code 995.20, the service may have been incorrectly denied
American Samoa, Guam, Hawaii, Nevada, Northern Mariana Islands: CPT codes 95044, 95052, 95056
  • If CPT codes 95044, 95052 or 95056 was submitted with one of the following ICD-9-CM codes, the service may have been incorrectly paid:

 ICD-9-CM Codes    

372.14-372.14  
381.00-381.06  
381.10-381.10
381.19-381.19
381.3-381.3
381.4-381.4    
381.50-381.52  
466.0-466.0
471.0-471.0
471.1-471.1
471.8-471.8
471.9-471.9    
472.0-472.0    
474.00-474.02  
474.10-474.12
477.0-477.0    
477.1-477.1    
477.2-477.2    
477.8-477.8    
477.9-477.9
478.11-478.11
478.19-478.19  
493.00-493.02  
49310-493.12   
493.20-493.22
493.90-493.92  
599.82-599.82  
693.0-693.0    
693.1-693.1    
693.8-693.8    
693.9-693.9    
708.0-708.0    
708.8-708.8    
708.9-708.9    
781.1-781.1   
782.1-782.1    
786.00-786.00  
786.05-786.05  
786.07-786.07  
786.2-786.2   
989.5-989.5    
989.81-989.83  
989.89-989.89  
995.0-995.0    
995.1-995.1   
995.20-995.23
995.27-995.27  
995.29-995.29  
995.3-995.3    
995.4-995.4   
995.60-995.69  
995.7-995.7
 
 
 
 
  • If CPT codes 95044, 95052 or 95056 was submitted with one of the following ICD-9-CM codes, the service may have been incorrectly denied:
ICD-9-CM Codes  

277.1-277.1

692.0-692.0
692.1-692.1
 692.2-692.2 692.3-692.3  
692.4-692.4    
692.5-692.5     
692.6-692.6   
692.70-692.74  
692.79-692.79  
692.81-692.84  
692.89-692.89   
692.9-692.9   
695.89-695.89  
695.9-695.9   
705.81-705.81
 
 
 
 
 

Modifier(s): Not Applicable

Remark /Reason Codes:
CARC (reason code) = 50
RARC (remark code) = N115
CO-15.4

MAC Action:
The Palmetto GBA system will be corrected. Mass adjustments have been completed to pay services incorrectly denied or recoup overpayment for services incorrectly paid.
  • 95 HI/NV claims with CPT 95044, 95052 or 95056 were identified as underpaid
  • Three HI/NV claims with CPT 95044, 95052 or 95056 were identified as overpaid
  • Two Northern California and five Southern California claims with CPT 86003 were identified as overpaid

Provider Action: None required 

Date Reported:  August 27, 2009
Date Resolved: October 30, 2009

 

last updated on 11/16/2009
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