Allergy Testing - Total Serum IgE Concentration
DESCRIPTION
Total serum IgE concentration allergy tests allows for measurement of the total IgE level in a serum sample. Elevated levels of IgE are associated with the presence of allergy. An example of testing for total serum IgE is the PRIST (paper radioimmunosorbent test). This test involves causing serum samples to react with IgE that has been tagged with radioactive iodine. Bound radioactive iodine, calculated upon completion of the test procedure, is proportional to the amount of total IgE in the serum sample.
POLICY
Total serum IgE concentration for diagnosis of allergic bronchopulmonary aspergillosis, immune deficiency disease characterized by increased IgE levels (e.g., Wiskott-Aldrich syndrome, hyper-IgE staphylococcal abscess syndrome), IgE myeloma, or pemphigoid is considered medically necessary.
See also: General Policy for Allergy Testing and Treatment
ADDITIONAL INFORMATION
There are few randomized controlled trials that substantiate this technology.
SOURCES
Agency for Healthcare Research and Quality. (2002, May). Management of allergic and nonallergic rhinitis. Retrieved April 1, 2008 from http://www.ahrq.gov/clinic/epcsums/rhinsum.pdf.
American Academy of Allergy, Asthma & Immunology. (1980). Physician reference materials: Position statement 6. Retrieved May 17, 2000 from http://www.aaaai.org/professional/physicianreference/positionstatements/ps06.stm.
Behrman, R. E., Kliegman, R. M., & Jenson, H. B. (Eds.). (2000). Behrman: Nelson textbook of pediatrics (16th ed., pp. 650-653). Philadelphia: W.B. Saunders Company.
BlueCross BlueShield Association. Medical Policy Reference Manual. (4:2006). Serial endpoint testing for the diagnosis and treatment of allergic disorders. (2.01.23). Retrieved April 1, 2008 from BlueWeb. (3 articles and/or guidelines reviewed)
Complete Guide to Medicare Coverage Issues [Computer software]. (2007, November). Food allergy testing and treatment - not covered (NDC 110.11, p. 2-54). St. Anthony Publishing.
Eppinger, T. M., Greenberger, P. A., White, D. A., Brown, A. E., & Cunningham-Rundles, C. (1999). Sensitization to aspergillus species in the congenital neutrophil disorders chronic granulomatous disease and hyper-IgE syndrome. Journal of Allergy and Clinical Immunology, 104 (6), 1265-1272.
Hayes. Medical Technology Directory. (2003, August). Allergy testing for diagnosis of allergic rhinitis, in vitro, quantitative. Retrieved April 1, 2008 from http://www.hayesinc.com/subscribers. (29 articles and/or guidelines reviewed)
Hayes. Medical Technology Directory. (2006, August). Allergy testing, in vivo. Retrieved April 1, 2008 from http://www.hayesinc.com/subscribers. (54 articles and/or guidelines reviewed)
Noble, J. (Ed.). (2001). Noble: Textbook of primary care medicine (3rd ed., pp. 1745-1747). St. Louis: Mosby, Inc.
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EFFECTIVE DATE |
5/8/2008 |
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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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