Ingestion challenge is used to confirm or rule out an allergy or to determine if a patient has outgrown an allergy. Codes for ingestion challenge testing are time based, but the time of service is the entire time of testing (including time of monitoring between ingestions) and not limited to the physician’s face-to-face time with the patient. However, the physician is required to be in the office suite or clinic and readily available for the entire testing time.

Time is met when the midpoint is passed (eg, 61 minutes is required to report code 95076) unless otherwise specified by health plan policy. The Table shows application of the midpoint rule to codes 95076 and 95079.

A 5-year-old boy with previously diagnosed peanut allergy presents to a pediatric allergist, who determines that an ingestion challenge is indicated based on recent negative blood and skin test results and history that...

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