DESCRIPTION
Provocative and neutralization therapy for food allergies involves the parenteral administration of offending allergenic extracts as antigens at periodic intervals. It begins with low doses to prevent untoward reactions, with gradually increasing doses injected to a dosage that is maintained as maintenance therapy. The goal is reduction of immune response.
POLICY
Provocative and neutralization therapy in the treatment of food allergies is considered investigational.
See also: General Policy for Allergy Testing and Treatment
IMPORTANT REMINDER
We develop Medical Policies to provide guidance to Members and Providers. This Medical Policy relates only to the services or supplies described in it. The existence of a Medical Policy is not an authorization, certification, explanation of benefits or a contract for the service (or supply) that is referenced in the Medical Policy. For a determination of the benefits that a Member is entitled to receive under his or her health plan, the Member's health plan must be reviewed. If there is a conflict between the Medical Policy and a health plan, the express terms of the health plan will govern.
ADDITIONAL INFORMATION
Published scientific evidence in the form of well-designed studies in peer-reviewed journals regarding the utilization of provocative and neutralization therapy for food allergies is lacking. There is insufficient evidence to permit conclusions regarding the impact of the use of provocative and neutralization therapy for food allergies regarding whether or not it improves net health outcomes.
SOURCES
American Academy of Allergy, Asthma & Immunology. (2003). Tips to remember: What is allergy testing? Retrieved July 22, 2003 from http://www.aaaai.org/patients/publicedmat/tips/whatisallergytesting.stm.
American Academy of Allergy, Asthma & Immunology. (1981). Physician reference materials: Position statement 8. Controversial techniques. Retrieved December 11, 2001 from http://www.aaaai.org/professional/physicianreference/positionstatements/ps08.stm.
Complete Guide to Medicare Coverage Issues [Computer software]. (2009, July). Food allergy testing and treatment - not covered (NCD 110.11, p. 2-56). The Ingenix Complete Guide to Medicare Coverage Issues.
ORIGINAL EFFECTIVE DATE: 10/12/1998
MOST RECENT REVIEW DATE: 2/11/2010
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.