Allergy Testing and Therapy (More Restrictive)

July 6, 2023

WellCare of New Jersey has made the following updates to Allergy Testing and Therapy Diagnosis Codes:

CP.MP.100 Allergy Testing and Therapy (more restrictive)

Codes 86160, 86161, and 86162 from not payable to not payable only when billed with the following diagnosis codes:

B44.81, H10.01* through H10.45, J30.1 through J30.9, J30.0, J31.0, J45.2* through J45.998, L20.84, L20.89, L20.9, L23.0 through L23.9*, L25.1 through L25.9, L27.0 through L27.9, L50.0, L50.1, L50.6, L50.8, L50.9, L56.1, L56.2, L56.3, R06.2, T36.0X5A through T50.995S, T63.001* - T63.94*, T78.00X* through T78.1XXS, T78.49XA through T78.49XS, T80.52XA through T80.52XS, T88.6XXA through T88.6XXS, Z88.0 through Z88.9, Z91.010 through Z91.018.

Add the following diagnosis codes as payable with 86003, 86005, 86008, 95004, 95017, 95018, 95024, 95027, and 95028. L20.0, L20.81-L20.83, L24.9, L30.2.

Add CPT 86001 as NOT payable.

For more information, contact your Provider Relations representative. Thank you for being our partner in health.