The ICD-9 code that reflects positive results from a current PPD test is 795.5 (Nonspecific reaction to tuberculin skin test without active tuberculosis). No specific code exists to describe personal history of a positive result. However, if a patient says that he has had a positive result in the past, you could retest him and use 795.5.
How to Identify a Positive Tuberculosis (TB) Skin Test
Also, diseases or medicines that weaken the immune system may cause a false-negative result. An abnormal (positive) result means you have been infected with the bacteria that cause TB. You may need treatment to lower the risk of the disease coming back (reactivation of the disease). A positive skin test does not mean that a person has active TB.
11 for Nonspecific reaction to tuberculin skin test without active tuberculosis is a medical classification as listed by WHO under the range - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified .
To bill for placing the purified protein derivative (PPD) skin test for tuberculosis, use CPT®code 86580. Use this code when the nurse or medical assistant places the test on the patient's skin. The CPT®definition of the code is: Skin test, tuberculosis, intradermal.
Z11. 1: “encounter for screening for respiratory tuberculosis now includes “encounter for screening for active tuberculosis disease.”
ICD-9-CM Diagnosis Code 010.90 : Primary tuberculous infection, unspecified, unspecified.
Namely, that if a patient presents for interpretation of the results of a PPD (purified protein derivative of tuberculin) test, it is appropriate to report CPT code 99211. CPT code 86580 is reported for the Mantoux test using the intradermal administration of purified protein derivative (PPD).
The patient's primary diagnostic code is the most important. Assuming the patient's primary diagnostic code is Z11. 1, look in the list below to see which MDC's "Assignment of Diagnosis Codes" is first. That is the MDC that the patient will be grouped into.
Z12. 11: Encounter for screening for malignant neoplasm of the colon.
9: Fever, unspecified.
ICD-10 Code for Personal history of latent tuberculosis infection- Z86. 15- Codify by AAPC.
How do we bill for placing the skin test for tuberculosis? To bill for placing the purified protein derivative (PPD) skin test for tuberculosis, use CPT ® code 86580. Use this code when the nurse or medical assistant places the test on the patient’s skin.
When the patient returns to have the nurse read the test, to see if it is positive or negative, then bill 99211. This is typically done in 48-72 hours. Remember that for Medicare, nurse visits must meet the criteria of incident to billing, so a physician or NPP must be in the office to bill Medicare for that service.
86580 is the correct code for billing the TB Skin Test otherwise known as the PPD. 90471 would be incorrect as this for a vaccine administration only. Z11.1 for Encounter for Screening for Respiratory TB would also be correct if the patient is there for a screening.
The reading of the PPD is not inclusive in the 86580. Depending on the office they may or may not charge for the reading of the PPD test. If they do charge for the reading the most common code is 99211 as the reading is normally completed by the providers staff.