DESCRIPTION
Radioallergosorbent (RAST) Test
This test causes serum samples to react with IgE that has been labeled (tagged) with radioactive iodine. The test measures the level of specific serum IgE antibodies.
Multiple Radioallergosorbent (MAST) Test
This in vitro test for specific serum IgE uses an enzymatic detection system in place of a radioactive label. Cellulose fibers that have been treated with different allergens are arranged inside a test chamber. During the individual's serum incubation, any IgE that is present will react with the allergen(s) on the cellulose fiber(s).
Fluorescent Allergosorbent (FAST) Test
This test uses the same principle as the RAST test, but uses a fluorescent enzymatic detection system.
POLICY
The specific IgE in vitro tests (RAST, MAST and FAST), for inhalant allergens (e.g., pollens, molds, dust, mites, animal danders), foods, insect stings and other allergens (e.g., drugs), are considered medically necessary if the medical appropriateness criteria are met. (See Medical Appropriateness below.)
The specific IgE in vitro tests (RAST, MAST and FAST), for the treatment of other conditions / disease are considered investigational.
MEDICAL APPROPRIATENESS
The specific IgE in vitro tests (RAST, MAST and FAST), are considered medically appropriate if ANY ONE of the following criteria are met:
Direct skin testing is impossible due to extensive dermatitis or marked dermagraphism
Performed on children less than four years of age
Direct skin testing has not been conclusive and further diagnostic testing is necessary
ADDITIONAL INFORMATION
Published scientific evidence in the form of well-designed studies in peer-reviewed journals regarding the utilization of specific IgE in vitro tests (RAST, MAST & FAST) for the treatment of other conditions / diseases is lacking. There is insufficient evidence to permit conclusions regarding the use of specific IgE in vitro tests for the treatment of other conditions / diseases instead of established alternatives or where the use of specific IgE in vitro tests for other conditions / disease improves net health outcomes.
SOURCES
American Academy of Allergy Asthma & Immunology. (2006). Tips to Remember: What is allergy testing? Retrieved June 7, 2006 from http://www.aaaai.org/patients/publicedmat/tips/whatisallergytesting.stm.
Sampson, H. A., Sicherer, S. H., & Birnbaum, A. H. (2001). American Gastroenterological Association practice guidelines: AGA technical review on the evaluation of food allergy in gastrointestinal disorders. Gastroenterology, 120 (4), 1026-1040.
ORIGINAL EFFECTIVE DATE: 10/12/1998
MOST RECENT REVIEW DATE: 12/10/2009
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.
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