BlueCross BlueShield of Tennessee Medical Policy Manual

Allergy Testing - Bronchial Challenge Test

DESCRIPTION

Histamine or methacholine is used to perform this test when it is necessary to determine if an individual has hyper-responsive airways. The testing may be performed using in 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

National Guideline Clearing House. (2001). AARC clinical practice guideline. Methacholine challenge testing: 2001 revision & update. Retrieved April 4, 2006 from http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=2845&nbr=2071.

EFFECTIVE DATE

4/13/2006

 

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.

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