Get Answers to Your 4 Most Frequently Asked 86580 Questions

Coding experts help us help you code TB skin tests and injection codes successfully every time

Before you report any tuberculosis (TB) related procedures (86580) look for documentation details on the patient's course of treatment after the initial skin test who interpreted the test results to the patient and the level of supercoder.com E/Mservices the pulmonologist provided because this will make or break your reimbursement.

Looking at these four frequently asked questions will determine whether you know how to report TB readings accurately. Write down your responses before looking to the correct answers below.

Question 1: Should I bill 99211 for tuberculosis (PPD) reading?

Question 2: We are trying to link the purified protein derivative (PPD) tuberculosis (TB) test to the correct ICD-9 code. We have been using V03.2 but we think that diagnosis is incorrect because V03.2 is a vaccination code. Which ICD-9 code should we report?

Question 3: Should I bill for an injection administration in addition to a tuberculosis (TB) skin test?

Question 4: When someone has a positive Mantoux (PPD) test and a negative chest x-ray and comes in for a visit to initiate INH (isonicotinic acid hydrazide called isoniazid) therapy what should we code? We code a moderate level office visit but what diagnosis should we use? We can't use tuberculosis because the chest x-ray was negative and if we use a V code we probably won't get paid.


Answer 1: You should report the initial purified protein derivative (PPD) tuberculosis test with 86580 (Skin test; tuberculosis intradermal).

Code 86580 does not cover any follow-up care. Therefore if the patient returns to the office to have the nurse evaluate the test's results you may report 99211 (Office or other outpatient visit for the evaluation and management of an established patient ...typically 5 minutes are spent performing or supervising these services).

Most plans will usually pay for the nurse visit with the screening diagnosis. If the payer denies 99211 you may appeal the claim or charge the patient.

Remember: Don't forget to collect a copayment for the 99211 services the pulmonologist provides at the follow-up visit.

Answer 2: You should report V74.1 (Special screening examination for bacterial and spirochetal diseases; pulmonary tuberculosis) with 86580 (Skin test; tuberculosis intradermal) for pulmonary tuberculosis says Denae M. Merrill CPC coding specialist with NEM Pulmonary Associates in Saginaw Mich.

When a nurse or other individual in your office administers a PPD TB test she gives an inoculation screening test not a vaccination.

The TB screen test detects the disease's presence by inoculating the skin with the TB antigen. The TB screen doesn't vaccinate the person. Instead the screen is an inoculation to confer disease immunity. Therefore you should link the test code to…..