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The ingestion challenge test is a diagnostic procedure used to identify specific allergies by observing the patient's reactions to various test items, which may include foods, drugs, or other substances. During this test, the patient sequentially and incrementally ingests these items under careful medical supervision. The physician closely monitors the patient for any allergic reactions that may occur, which helps in determining the presence of allergies to the ingested substances. The test is designed to replicate normal food consumption, taking into account the amount and state of the food or substance ingested. The observation period following ingestion is critical, as it aligns with the typical time frame for the onset of allergic symptoms based on the patient's medical history. For accurate coding, the initial 120 minutes of the ingestion challenge test is reported using CPT® code 95076, while CPT® code 95079 is utilized to report each additional 60 minutes of testing beyond the initial period.
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The ingestion challenge test is indicated for patients who exhibit symptoms suggestive of food or drug allergies. This test is particularly useful in the following scenarios:
The ingestion challenge test involves several procedural steps to ensure accurate assessment of the patient's allergic responses. Each step is critical for the safety and effectiveness of the test.
After the ingestion challenge test, the physician evaluates the patient's reactions and provides appropriate follow-up care based on the findings. Patients may be advised to avoid any identified allergens and may receive instructions on managing allergic reactions. Documentation of the test results and any recommendations for future dietary or medication restrictions is essential for ongoing patient care. Additionally, the physician may schedule follow-up appointments to monitor the patient's condition and address any further concerns related to allergies.
| Short Descr | INGEST CHALLENGE ADDL 60 MIN | Medium Descr | INGESTION CHALLENGE TEST EACH ADDL 60 MINUTES | Long Descr | Ingestion challenge test (sequential and incremental ingestion of test items, eg, food, drug or other substance); each additional 60 minutes of testing (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | T2D - Other tests - other | MUE | 2 | CCS Clinical Classification | 173 - Other diagnostic procedures on skin and subcutaneous tissue |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 95076 | MPFS Status: Active Code APC S Ingestion challenge test (sequential and incremental ingestion of test items, eg, food, drug or other substance); initial 120 minutes of testing |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CR | Catastrophe/disaster related | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GZ | Item or service expected to be denied as not reasonable and necessary | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2013-01-01 | Added | Added |
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