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CPT 95004: Percutaneous Allergen Skin Test
CPT code 95004 represents a percutaneous allergen skin test used to identify substances that provoke IgE-mediated allergic reactions. This diagnostic procedure is commonly performed in outpatient allergy or immunology clinics and informs clinical management for allergic rhinitis, asthma triggers, drug or food sensitivities, and other allergic conditions. Nationally, accurate coding for skin testing is important for care coordination, quality measurement, and appropriate reimbursement for allergy diagnostic services.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical purpose of CPT code 95004, expected sites of service, and the role of the test in differential diagnosis and treatment planning. The publication outlines common billing considerations, typical modifiers in use, and how payers approach coverage in general terms. It also summarizes relevant benchmarks and policy updates where available. The content is intended to help billing professionals, clinicians, and practice managers understand the clinical context and billing landscape for percutaneous allergen testing on a national scale.
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Billing Code Overview
CPT code 95004 describes a percutaneous allergen testing procedure in which a provider applies allergenic extracts to the patient's skin to determine which substances trigger an allergic reaction. The test is used to identify IgE-mediated sensitivities by observing localized skin responses to applied extracts.
Service Type: Diagnostic allergy testing
Typical Site of Service: Outpatient clinic or office-based allergy/immunology setting, including specialty practices where skin testing is performed under medical supervision.