Billing and Coding: Allergy Testing

Allergy testing is covered when the medical record documents a history indicating possible allergy and demonstrates that antigen selection was patient-specific and that testing was limited to the minimal necessary number of skin tests. CPT 82785 and routine use of CPT 86003 with skin testing are generally not appropriate; strict medical-record documentation (legible patient identifiers, provider signature, ICD-10 support, test type, interpretations, and wheal/erythema measurements) is required. Refer to LCD L33261 for detailed medical necessity and frequency guidelines.

"Allergy testing is covered when the medical record contains documented history obtained prior to testing that indicates the possible presence of allergy."

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