Name of Manual - Blue Cross and Blue Shield of Minnesota

Preventive Medicine
(continued)
Coding Policies and Guidelines (Medical Services)
The documentation for the E/M must not be combined into or be
part of the documentation for the preventive physical. The
problem(s) addressed must be significant enough to require
additional work. All key components for the level E/M reported
must be met and supported.
Developmental testing, 96110 or 96111, is considered part of an
age appropriate preventive medicine E/M and as such, will deny if
billed in addition to the exam. Exceptions are made only for our
Public Program members (PMAP and MNCare).
Hospital Discharge Hospital discharge services, 99238 or 99239, can only be billed
when services are performed on the actual date the patient left the
hospital. A discharge is not billable for a patient’s death.
Allergy Testing Allergy testing (95004-95075) refers to the evaluation of selective
cutaneous and mucous membrane tests to assist in the
determination of appropriate immunotherapy.
Allergy
Immunotherapy
Submit the number of services in accordance with the CPT
description.
Allergy tests and their interpretation are a single entity; do not
submit separately. An office visit with the modifier –25 may be
submitted in addition to allergy testing only when additional
identifiable services are provided.
Code 95115 should be submitted with one unit of service when
one injection is given.
Code 95117 should be submitted with one unit of service when
multiple injections are given (regardless of the number of
injections).
Codes 95120-95134 should be submitted with one unit of
service. 95145-95180 should be submitted with the number of
services in accordance with the CPT description.
Codes 95115 and 95117 include professional services
necessary for allergen immunotherapy.
A level-of-service office visit with modifier –25 may be submitted
in addition to an allergy injection only when additional identifiable
services are provided.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (06/20/12)
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