Allergy Testing

Medically necessary allergy testing includes in vivo skin tests (percutaneous, intracutaneous, patch, dilutional SET), organ challenge tests (ocular, nasal, inhalation, oral food challenges) and in vitro specific IgE assays when guided by a clinical history and physical exam. Testing must be targeted to likely allergens, use validated methods with appropriate controls, be performed by qualified providers, and excludes numerous nonvalidated or investigational techniques (e.g., IgG food testing, electrodermal testing, provocation-neutralization); routine large-panel or annual testing without clinical indication is not covered.

"Percutaneous (scratch/prick/puncture) skin testing is medically reasonable and necessary to evaluate IgE-mediated hypersensitivity to inhalants, foods, Hymenoptera venoms (stinging insects), chemic..."

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