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RAST Type Tests CPT: 86003

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RAST Type Tests CPT: 86003 Medicare Local Coverage Determination Policy Allergy Testing RAST Type Tests CPT: 86003 Medically Supportive CMS Policy for Kentucky and Ohio ICD Codes are listed Local policies are determined by the performing test location. This is determined by the state on subsequent page(s) in which your performing laboratory resides and where your testing is commonly performed. of this document. Coverage Indications, Limitations, and/or Medical Necessity Radioallergosorbent test (RAST), fluoroallergosorbent test (FAST), and multiple antigen simultaneous tests are in vitro techniques for Add full policy information determining whether a patient's serum contains IgE antibodies against specific allergens of clinical importance. As with any allergy testing, the need for such tests is based on the findings during a complete history and physical examination of the patient. The multiple antigen simultaneous testing technique is similar to the RAST/FAST techniques in that it depends upon the existence of Template structure: allergic antibodies in the blood of the patient being tested. With the multiple antigen simultaneous test system, several antigens may be used to test for specific IgE simultaneously. First level is for headers such as limitations, ELISA (enzyme-linked immunosorbent assay) is another in vitro method of allergy testing for specific IgE antibodies against allergens. indications and usage guidelines This method is also a variation of RAST. Second level is for main body copy Limitations • Third level is for bullet (if needed) The following tests are considered to be not medically necessary and will be denied. • ELISA/Act qualitative antibody testing. This testing is used to determine in vitro reaction to various foods and relies on lymphocyte blastogenesis in response to certain food antigens. • LMRA (Lymphocyte Mitogen Response Assays) by ELISA/Act To apply styles to copy, select copy and use the • IgG ELISA, indirect method (CPT code 86001) “promote” and “demote” under the home tab • Qualitative multi-allergen screen (CPT code 86005). This is a non-specific test that does not identify a specific antigen. • IgG and IgG subclass antibody tests for food allergy do not have clinical relevance, are not validated, lack sufficient quality control, and should not be performed. Helpful hint: be sure to hit “Reset” button to apply master once all copy is in template to apply styles Visit QuestDiagnostics.com/MLCP to view current limited coverage tests, reference guides, and policy information. Right Click “Hyperlink” to Add CMS URL To view the complete policy and the full list of medically supportive codes, please refer to the CMS website reference www.cms.gov ► Medicare Local Coverage Determination Policy Allergy Testing RAST Type Tests CPT: 86001, 86003 Please refer to the Limitations Add frequency verbiage CMS Policy for Kentucky and Ohio or Utilization Guidelines Local policies are determined by the performing test location. This is determined by the state section on previous page(s) in which your performing laboratory resides and where your testing is commonly performed. for frequency information. If there is a frequency associated with test, use copy: There is a frequency associated with this test. Please refer The ICD10 codes listed below are the top diagnosis codes currently utilized by ordering physicians for the limited coverage test to the Limitations or Utilization Guidelines section on highlighted above that are also listed as medically supportive under Medicare’s limited coverage policy. If you are ordering this previous page(s). test for diagnostic reasons that are not covered under Medicare policy, an Advance Beneficiary Notice form is required. *Note—Bolded diagnoses below have the highest utilization If no frequency associated with test, use copy: Please refer to the Limitations or Utilization Guidelines Code Description section on previous page(s) for frequency information. J30.9 Allergic rhinitis, unspecified For Code pasting from excel workbook: right click, Paste Options “Keep Text Only” If table format shows up in template, right click and select “Keep Text Only” to reformat Visit QuestDiagnostics.com/MLCP to view current limited coverage tests, reference guides, and policy information. To view the complete policy and the full list of medically supportive codes, please refer to the CMS website reference www.cms.gov ► Right Click “Hyperlink” to Add CMS URL Last updated: 11/6/19 Add “Last updated” date Disclaimer: QuestDiagnostics.com This diagnosis code reference guide is provided as an aid to physicians and office staff in determining when an ABN (Advance Beneficiary Notice) Quest, Quest Diagnostics, any associated logos, and all is necessary. Diagnosis codes must be applicable to the patient’s symptoms or conditions and must be consistent with documentation in the associated Quest Diagnostics registered or unregistered patient’s medical record. Quest Diagnostics does not recommend any diagnosis codes and will only submit diagnosis information provided trademarks are the property of Quest Diagnostics. All third-party to us by the ordering physician or his/her designated staff. The CPT codes provided are based on AMA guidelines and are for informational marks—® and ™—are the property of their respective owners. purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed. © 2016 Quest Diagnostics Incorporated. All rights reserved. .
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