Allergy Testing - Bronchial Challenge Test
DESCRIPTION
Histamine or methacholine is used to perform the Bronchial Challenge test when it is necessary to determine if an individual has hyper-responsive airways. The testing may be performed using an isolated chamber or with an exposure system designed to measure and control the concentration of test substances. The individual inhales gradually increasing concentrations of the suspected substance while pulmonary function is monitored. Volatile chemicals are used to perform the test when the symptoms are encountered in an occupational setting.
POLICY
Bronchial challenge testing with histamine or methacholine to determine a hyper-responsive airway is considered medically necessary.
Bronchial challenge testing with volatile chemicals to determine if the immune response is encountered in an occupational setting is considered medically necessary.
Bronchial challenge testing for the diagnoses of cough variant asthma or atypical asthma is considered medically necessary.
Bronchial challenge testing, when common allergens (e.g., dust, pollens, molds, etc.) are the suspected cause of a hyper-responsive airway, is considered not medically necessary.
See also: General Policy for Allergy Testing and Treatment
ADDITIONAL INFORMATION
Skin tests (percutaneous, intracutaneous test) can be used if common allergens (e.g., dust, pollens, molds, etc.) are the suspected cause of a hyper-responsive airway.
SOURCES
American Association of Respiratory Care. (2001, May). AARC clinical practice guidelines for Methacholine challenge testing: 2001 revision and update. Retrieved January 12, 2009 from http://www.rcjournal.com/cpgs/mctcpg-update.html.
Bimbaum, S., & Barreiro, T., Methacholine Challenge Testing: identifying its diagnostic role, testing, coding, and reimbursement. (2007) Chest, 131 (6), 1932-1935.
ORIGINAL EFFECTIVE DATE: 10/12/1998
MOST RECENT REVIEW DATE: 2/12/2009
ID_BT
Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.
This document has been classified as public information.