Reader Questions: Food Allergy Testing

Question: Is food allergy testing covered and payable by Medicare or other carriers? My physician devotes a significant portion of his practice to food allergy testing and treatment. The local Medicare carrier in Florida does not cover ALCAT allergy testing, although some commercial carriers do.

Texas Reader

Answer: Food allergy testing is done several ways: blood tests (ALCAT or RAST), skin testing or provocative testing (which involves putting drops under the tongue and determining how many drops the patient can tolerate before a reaction occurs).

With the exception of skin testing, most carriers do not pay for food allergy testing, in part because some of the tests (RAST and provocative) currently are not fully recognized, and in part because testing in general often is not accurate enough to guarantee that an allergy will be detected (the state of the food causing the allergy changes inside the body).

Furthermore, having patients record what they eat in a food diary and counseling them on how to track and limit foods, as well as add foods one at a time, may be just as effective as food allergy tests in determining the cause of the allergy.

Intradermal (skin) tests for food allergies may be payable, however, depending on the patients diagnosis. Such tests are coded 95024 (intracutaneous [intradermal] tests with allergenic extracts, immediate type reaction, specify number of tests) the same as non-food allergy skin tests. If end-point titration is involved, 95027 (skin end point titration) should be billed.

In special situations (for example, if the patient requires a food allergy test and cannot tolerate a skin test), some carriers may pay for a RAST blood test.

Note: Although Medicare carriers may pay for food allergy testing, they do not cover food desensitization services.

Reader Questions answered by Susan Callaway, CPC, CCS-P, an independent coding and reimbursement specialist and educator in North Augusta, S.C.; and Teresa Thompson, CPC, an allergy coding and reimbursement specialist in Sequim, Wash.

- Published on 2001-06-01