Updated Policy for Allergen Specific IgE Testing

Effective for dates of services on or after May 1, 2013, policy and documentation requirements for CPT code 86003 (allergen specific IgE; quantitative or semiquantitative, each allergen) have been updated to include the following criterion:

• The patient has persistent asthma (requiring treatment at Step 2 or higher according to NAEPP 2007), and the test is needed to determine the potential sensitivity to perennial indoor inhalant allergens to which the patient is exposed.

Additionally, explanation as to why other allergy tests were not satisfactory must be provided in order to justify medical necessity for the allergy testing procedure.

Source: General Medicine | April 2013 | Bulletin 466