DESCRIPTION
The leukocyte histamine release test (LHRT) measures the amount of histamine released in-vitro. An allergen extract in varying concentrations is added to the peripheral blood leukocytes of the individual being tested. Histamine is normally released as a consequence of the interaction of allergen with cell-bound IgE antibodies. If an individual is hypersensitive to a specific antigen, the leukocytes will release the histamine in-vitro. Only a limited number of allergens can be tested from a single sample of blood. Quality control studies have shown variability in the measurement of histamine results.
POLICY
The leukocyte histamine release test in the diagnosis of allergies is considered investigational.
See also: General Policy for Allergy Testing and Treatment
ADDITIONAL INFORMATION
Clinical data supporting the role of leukocyte histamine release testing in the diagnosis of allergies is lacking.
The leukocyte histamine release test does not meet the following technology evaluation criteria:
The scientific evidence must permit conclusions concerning the effect of the technology on health outcomes.
The technology must improve the net health outcome.
The technology must be as beneficial as any established alternatives.
The improvement must be attainable outside the investigational settings.
SOURCES
American Academy of Allergy, Asthma & Immunology. (1975, September). Physician Reference Materials: Position Statement 2. Some untested diagnostic and therapeutic procedures in clinical allergy. Retrieved November 9, 2001 from http://www.aaaai.org/professional/physicianreference/positionstatements/ps02.stm.
BlueCross BlueShield Association. Medical Policy Reference Manual. (3:2005). Leukocyte histamine release test (2.04.42). Retrieved May 17, 2006 from BlueWeb.
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EFFECTIVE DATE |
6/22/2006 |
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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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