Medical Policy: 02.01.02 

Original Effective Date: November 2003 

Reviewed: February 2021 

Revised: February 2021 



This policy contains information which is clinical in nature. The policy is not medical advice. The information in this policy is used by Wellmark to make determinations whether medical treatment is covered under the terms of a Wellmark member's health benefit plan. Physicians and other health care providers are responsible for medical advice and treatment. If you have specific health care needs, you should consult an appropriate health care professional. If you would like to request an accessible version of this document, please contact customer service at 800-524-9242.


Benefit Application:

Benefit determinations are based on the applicable contract language in effect at the time the services were rendered. Exclusions, limitations or exceptions may apply. Benefits may vary based on contract, and individual member benefits must be verified. Wellmark determines medical necessity only if the benefit exists and no contract exclusions are applicable. This medical policy may not apply to FEP. Benefits are determined by the Federal Employee Program.


This Medical Policy document describes the status of medical technology at the time the document was developed. Since that time, new technology may have emerged or new medical literature may have been published. This Medical Policy will be reviewed regularly and be updated as scientific and medical literature becomes available.



Allergic or hypersensitivity disorders can manifest themselves as generalized systemic reactions as well as localized reactions in any organ system of the body. Numerous agents, e.g., pollen, mold, dust mites, animal dander, insect stings, foods or drugs may precipitate allergic or hypersensitive reactions. For details on treatment of allergies, see Policy 02.01.01, Allergy Immunotherapy.


Allergy is a hypersensitive reaction that is usually manifested in the clinical form of allergic asthma, hay fever or eczema developing within minutes to a few hours after exposure to an antigen. The most common types of allergies are rhinitis, asthma, food allergy, insect sting allergy, drug allergy and contact dermatitis. Allergy testing is focused on determining what allergens cause a particular reaction and the degree of the reaction and provides justification for recommendations of specific avoidance measures in the home or work environment or the institution of particular medicines or immunotherapy. There are virtually no age limitations for performance of skin tests. However, skin test reactivity may be diminished in infants and the elderly. Types of allergy testing include in vivo, in vitro, provocation testing, and controversial allergy tests. The umbrella term ‘food hypersensitivity or food sensitivities’ can be used to describe any ‘adverse reaction to food’. The term ‘food allergy’ refers to the subgroup of food-triggered reactions in which immunologic mechanisms have been implicated, whether IgE- mediated, non-IgE-mediated, or involving a combination of IgE- and non-IgE-mediated etiologies. All other reactions to food that were in the past sometimes referred to as ‘food intolerance’ or ‘food sensitivities’ constitute non-allergic food hypersensitivity reactions and are not considered allergies.


Allergy tests detect the presence of IgE antibodies to a particular allergen, or something that causes an allergic reaction. A positive test suggests allergic sensitization to a specific allergen. There are several in-vitro tests available to diagnose allergies, however, the National Medical and Research Center believes that standard intradermal or epicutaneous skin tests in correlation with a thorough medical history and physical examination best serves the patient. A positive skin test alone does not diagnose an allergy; it must correlate with symptoms experienced when the patient has an allergen exposure.


Ideally, the clinical history should provide enough information to form an opinion about whether a patient’s symptoms are due to allergies and if so, what they are likely to be allergic to. The purpose of a diagnostic test is to determine whether a patient’s symptoms are caused by an allergic disease as opposed to other common causes. Diagnostic testing also can better define the specific triggers when the history alone is unclear. Neither allergy blood testing nor skin testing should be used for screening: they are most useful as confirmatory tests when the patient’s history is compatible with an IgE-mediated reaction.


Skin and in vitro testing

The management of an allergic patient should include a comprehensive history, physical examination and should include confirming the cause of allergies.  Once the agent is identified, treatment is provided by avoidance, medication or immunotherapy. The physician supervised oral food challenge remains the gold standard for food allergy diagnosis. Skin testing would be the first line of testing for the majority of patients. In vitro testing would be appropriate for those with the inability to stop specific medications and those that have had severe allergic responses to medicine, food, inhalants, and insects. It would be inappropriate to use in vitro testing as the first line of testing unless specific indications are present.


The advantage of skin tests is that they are rapid, sensitive and specific, safe and relatively inexpensive per test. The disadvantages of skin tests are that there is a small risk of a systemic reaction.  The sensitivity of blood allergy testing is approximately 25% to 30% lower than that of skin testing, based on comparative studies.


The skin of infants may be less reactive, yielding more false-negative results, although this difference has not been formally studied. Nevertheless, positive results are commonly obtained in infants with a history consistent with food allergy. Thus, skin testing can be performed even in infants and young children (greater than 6 months of age) when indicated and with appropriate precautions.


The blood tests for allergic disease are immunoassays that measure the level of IgE specific to a particular allergen. Levels of specific IgE have been shown to depend on age, allergen specificity, total serum IgE, and, with inhalant allergens, the season of the year. Evidence of sensitization to a particular allergen (ie, a positive blood test result) is not synonymous with clinically relevant disease (ie, clinical sensitivity). In Vitro Specific IgE levels higher than 0.35 KU/L suggests sensitization but do not correlate with clinical disease in all situations. Different commercial specific IgE assays are also not always equivalent. In vitro allergy blood tests can give false positive results due to nonspecific binding of antibody in the assay. Prospective studies exist to identify IgE levels that may predict clinical reactivity with greater than 95% certainty. This level of understanding does not exist for all foods, drugs, latex or allergens. Allergen testing in serum is designed to detect the presence of allergen-specific IgE. A positive test for allergen-specific IgE confirms the presence of the antibody only. Actual reactivity must be determined by history or supervised challenge. 


IgG antibodies to allergens such as foods can be detected and quantified by Unicap or ELISA techniques. The presence of IgG antibodies, however, does not indicate allergy to these environmental substances. Detection of IgG antibodies, IgG subclasses, or IgG/IgG4 antibody ratios were discredited as reliable diagnostic tools.


Food-specific IgG4 does not indicate (imminent) food allergy or intolerance, but rather a physiological response of the immune system after exposition to food components. Therefore, testing of IgG4 to foods is considered as irrelevant for the laboratory work-up of food allergy or intolerance and should not be performed in case of food-related complaints.


Patch Testing

Patch testing can be performed either using a preloaded thin-layer rapid use epicutaneous testing kit of 36 chambers or with a panel of antigens loaded individually in a chamber system recommended by the North American Contact Dermatitis Group (NACDG) Research Group or the American Contact Dermatitis Society (ACDS). The patch test procedure can induce an eczematous reaction in miniature by applying suspect allergens to normal skin, allowing the physician to determine a specific patient allergy. Patch tests are applied to the skin on the patient's back and left in place for 48 hours. The test is interpreted after 48 hours, and typically once again at 72 hours or 96 hours, and the reactions are systemically scored and recorded. The patient is then informed and educated regarding specific allergies and avoidance of exposure. Avoidance of the identified allergen(s) is critical to patient improvement and resolution of the dermatitis.


Photo Testing

Some chemicals produce an allergic reaction only when exposed to light (usually ultraviolet type A light, UVA). Patients who are oversensitive to light and those with a rash that appears on parts of the body normally exposed to light (mostly the face, the 'V' of the neck and the hands) but that does not appear in areas shielded from the light (eg under the chin and the triangle between the nose and the mouth) should have a photo or phot-patch test to determine if light is causing the allergic reaction. Photo testing and photo patch testing are indicated to evaluate a nonspecific photo sensitive dermatitis, photo sensitive allergic contact dermatitis or photo sensitive pruritus, to determine the causative antigen. Photo-patch testing should be done in clinical settings with the expertise, materials, and equipment to perform the procedure. In brief, duplicate applications of the suspected photo-sensitizer(s) are placed on either side of the upper back, and occluded for 24 to 48 hours. A recent study suggests that 2 days of occlusion before irradiation of allergens is more sensitive at detecting photoallergy. After patch removal, one side of the back is then irradiated with 5 J cm 2 of UVA and the other side is left open but untreated as the control. Both irradiated and unirradiated sides are then measured 48 hours after irradiation for a response. Photo tests are used to evaluate skin abnormalities—such as rash, itching, blisters, and hives—that are either caused or exacerbated by exposure to sunlight. In standard photo tests, small areas of skin are irradiated with different doses of long- and short-wave ultraviolet (UVA and UVB) and visible light, and then observed for a reaction.


The American Academy of Allergy Asthma and Immunology (AAAAI) Expert Panel suggests that the atopy patch test should not be used in the routine evaluation of noncontact food allergy. Insufficient evidence exists to support the use of the atopy patch test for the evaluation of food allergy. Although a number of studies have reported that the patch testing may be useful in the evaluation of food allergies in patients with atopic dermatitis and eosinophilic esophagitis, there is no agreement on the appropriate reagents, methods, or interpretation of these tests. When compared with oral food challenges, patch testing shows highly variable sensitivity and specificity among different studies.


Basophil Activation (BAT)

Basophil activation test simulates an oral challenge, in a test tube. The patient’s blood is drawn, exposed to the allergen and the basophils – immune cells involved in a reaction – are analyzed using flow cytometry.


Epitope Mapping

This food allergy test involves a proprietary epitope mapping platform that looks at how a patient’s IgE antibodies bind to individual parts of the protein’s components, called epitopes.


Practice Guidelines and Position Statements

The American Board of Internal Medicine’s (ABIM) Foundation Choosing Wisely® Initiative (2014):

The Choosing Wisely initiative includes the following recommendations from the American Academy of Asthma, Allergy, and Immunology regarding allergy testing:

  • Don’t perform unproven diagnostic tests, such as immunoglobulin G (IgG) testing or an indiscriminate battery of immunoglobulin E (IgE) tests, in the evaluation of allergy
  • Don’t routinely do diagnostic testing in patients with chronic urticaria.
  • Don’t perform food IgE testing without a history consistent with potential IgE-mediated food allergy.


One of the AAAAI’s (American Academy of Allergy, Asthma and Immunology) “Five Things Physicians and Patients Should Question” (2012) noted that “Appropriate diagnosis and treatment of allergies requires specific IgE testing (either skin or blood tests) based on the patient’s clinical history. The use of other tests or methods to diagnose allergies is unproven and can lead to inappropriate diagnosis and treatment”. The AAAAI stated that “Don’t perform unproven diagnostic tests, such as immunoglobulin G (IgG) testing or an indiscriminate battery of immunoglobulin E (IgE) tests, in the evaluation of allergy”.


Measurement of allergen-specific IgG or IgG4 antibodies in the evaluation of food allergy is considered a test of unproven or no value by the American Academy of Allergy, Asthma & Immunology - AAAI, American College of Allergy, Asthma & Immunology - ACAAI, the Joint Council of Allergy, Asthma and Immunology - JCAAI, and the American Gastroenterological Association - AGA.


The American Academy of Allergy, Asthma and Immunology (AAAAI) and the American College of Allergy, Asthma and Immunology (ACAAI):

Updated Practice Parameter (2012) states: Summary Statement 127. 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.


European Academy of Allergy and Clinical Immunology (EAACI) Food Allergy and Anaphylaxis Guidelines: diagnosis and management of food allergy:

Evidence of IgE sensitization to common food and appropriate aeroallergens can support a diagnosis of food allergy in conjunction with clinical history and/or food challenge. The clinical utility of measuring serum food IgE and to generate a successful elimination diet needs further investigation. There are no unconventional tests which can be recommended as an alternative or complementary diagnostic tool in the workup of suspected food allergy, and their use should be discouraged.


World Allergy Organization

The general recommendations include:

  1. Procedures for the diagnosis and treatment of allergic diseases should be performed by medical personnel (physician/nurse/technician) fully aware of risks associated with the procedure and trained in the recognition and management of allergic emergencies, including anaphylaxis.
  2. Some procedures can be performed by trained nurse/technician, but always under close supervision of the allergist.
  3. Although most procedures can be done in both outpatient and hospital settings availability of appropriate rescue service should be secured.
  4. Basic emergency equipment and rescue medications should be available on site during each allergy procedure.
  5. Depending on the type of procedure emergency staff (ICU) should be available on site or should be reached within a specified time.
  6. Before a procedure is initiated, contra-indications should be considered and risk/benefit ratio for each procedure should be assessed.
  7. The patient should receive full information on the purpose and potential adverse effects associated with each procedure and for some procedures should be asked to sign an informed consent.
  8. If anaphylaxis or severe reactions are likely, intravenous access should be secured before the procedure is started.
  9. Continuous monitoring of patient by authorized personnel during is the procedure necessary to secure safety of performed procedure.
  10. After the procedure is completed the patient should remain under close supervision for a specified period of time.
  11. Before the patient is released, she or he should be provided with appropriate instruction in how to handle potential adverse symptoms and what to do in case of an emergency.


Prior Approval:

Not applicable



For details on treatment of allergies, see Policy 02.01.01, Allergy Immunotherapy.


The following allergy tests are considered medically necessary, if the following indications are met, with the following limits:


Skin Testing and Intracutaneous Testing

Percutaneous (scratch, puncture, prick) and intracutaneous (intradermal) allergy testing are considered medically necessary and, therefore, covered for the diagnosis, evaluation, and treatment of allergies when there are signs and symptoms or a diagnosis suggestive of an allergy. Skin testing may be used for the evaluation of allergen-specific IgE to inhalants, foods, drugs and venom in the following conditions: respiratory/inhalant allergy, food allergy, venom allergy, drug allergy. Intradermal testing has no place in aeroallergen and food allergen testing. It is most commonly used in testing for drug and venom allergy.


Percutaeous testing has the following limitations:


A total of 70 scratch, puncture, or prick allergy tests are eligible for reimbursement per calendar year (CPT code 95004).


A total of 40 intracutaneous allergy tests (which should only follow negative scratch, puncture, or prick tests) are eligible for reimbursement per calendar year (CPT codes 95024 and 95028).


Serial Endpoint Testing

Skin serial endpoint titration (SET) for determination of a safe starting dose for testing (e.g., pre-operative testing, safe starting dose for therapy/antibiotics/biologics) or immunotherapy when there is potential for the specific allergen in question to produce a severe systemic reaction or anaphylaxis and it is an approved indication for immunotherapy. Serial endpoint titration (SET) testing (eg, intradermal dilutional testing [IDT]) is considered medically necessary with a total of 80 tests being eligible for reimbursement for CPT code 95027, 27 tests being eligible for reimbursement for CPT code 95017, or 19 tests eligible for reimbursement for CPT code 95018.


Patch Testing

Patch testing is the gold standard method of identifying the cause of allergic contact dermatitis. This testing is indicated to evaluate:

  • nonspecific dermatitis
  • allergic contact dermatitis
  • pruritus


to determine the causative antigen. It is a diagnostic test reserved for patients with skin eruptions for which a contact allergy source is likely.


Patch testing (95044) is limited to 42 units.


Standard panels of allergens for patch testing are available from various commercial sources. Each standard patch test unit includes 35 common allergens and a negative control. In addition to the standard series of 36 patch tests, six (6) additional allergens may be performed initially. Allergy testing in excess of the above limits is considered not medically necessary.


Patch test should not be used in the routine evaluation of noncontact food allergy. Insufficient evidence exists to support the use of the atopy patch test for the evaluation of food allergy. Patch testing for food allergy will be considered not medically necessary.


Patch testing outside of these diagnoses will be considered not medically necessary.


Photo Testing

Photo testing (95056) and photo patch testing (95052) are indicated to evaluate:

  • photo sensitive nonspecific dermatitis
  • photo sensitive allergic contact dermatitis and
  • photo sensitive pruritus


Photo testing is limitied to 20 units. Photo testing and photo-patch testing outside of these diagnosis or quantity limits will be considered not medically necessary.


Multiallergen screening (CPT code 86005) is a qualitative test that does not quantify specific antigens; therefore, it is considered not medically necessary and not covered. Multiallergen screening is considered not medically necessary and, therefore, not covered because the available published peer-reviewed literature does not support its use in the treatment of illness.


The following allergy tests are considered investigational because the scientific literature has not provided proof of their efficacy:

  • Provocative tests (e.g. Rinkel test) for food or food additive allergies
  • Nasal challenge test
  • Conjunctival challenge test
  • Leukocyte histamine release test (LHRT)
  • Rebuck Skin Window test
  • Passive transfer or P-X (Prausnitz-Kustner) test (replaced by radioallergosorbent test)
  • Cytotoxic food testing
  • Cyrex testing
  • Food Sensitivities/LEAP Substance Profile Testing/(Mediator Release Testing)
  • ALCAT test (e.g., precision diagnostics panel testing)
  • Any blood or saliva test panel for food sensitivities or food allergies including SAGE testing for food delayed sensitivity and Biotek food allergy panel
  • Any testing related to the Nambudripad's Allergy Elimination Technique (NAET)
  • Any IgG in-vitro assay used for evaluation
  • Sublingual allergy desensitization to aerollergens not recommended by the American Academy of Allergy
  • HEMOCODE food intolerance testing
  • Immune Blood Print test
  • Reaginic pulse test or pulse testing for allergies
  • Chemical analysis of body tissues
  • Basophil Activation Testing
  • Epitope Mapping


In-Vitro Allergy Testing

The use of in vitro (blood) (86003) allergy testing for IgE should be limited to individuals where skin testing is not possible. There would rarely be a need for testing beyond 36 tests per year. Testing implemented beyond 36 tests will be denied as not medically necessary.


Specific IgE in vitro tests (86003 or 86008) for inhalant allergens (pollens, molds, dust, mites, animal danders) anaphylactic shock due to foods or insect sting, or for evaluation of cross-reactivity between insect venoms may be considered medically necessary when the following criteria are met:

  • Direct skin testing is impossible due to an extensive dermatitis or eczema
  • Direct skin testing results are not consistent with a history of anaphylactic or other severe reaction to an allergen and further treatment decisions would be impacted by confirmation of sensitivity;
  • Inability to discontinue medication (e.g., antihistamines, beta-blockers, MAO inhibitors, long-term tricyclics) that impair skin test sensitivity.


*Specific IgE in vitro testing is considered medically necessary only after physician determination that one of the aforementioned conditions precludes the use of direct skin testing. Specific IgE in vitro tests should be used judiciously and include testing only for those allergens that could be reasonably suspected regardless of test kit packaging. Diagnostic screening is limited to 36 allergen specific antibodies but must be personalized to the individual.


Testing for other immunoglobulin (e.g. IgG, IgG4, IgA, IgM, IgD) or subclasses to determine allergies is considered investigational.


Precision diagnostics for food allergy with non-personalized large panel testing is considered investigational


Allergy testing is generally considered diagnostic: retesting is considered not medically necessary on an annual or more frequent basis.


Procedure Codes and Billing Guidelines:

To report provider services, use appropriate CPT* codes, Modifiers, Alpha Numeric (HCPCS level 2) codes, Revenue codes, and/or diagnosis codes.

  • 82784 Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each
  • 82787 Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each
  • 83516 Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method
  • 86001 Allergen specific IgG quantitative or semiquantitative, each allergen
  • 86003 Allergen specific IgE; quantitative or semiquantitative, each allergen
  • 86005 Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card)
  • 86008 Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each
  • 86343 Leukocyte histamine release test (LHR)
  • 86849 Unlisted immunology procedure
  • 95004 Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction, including test interpretation and report, specify number of tests
  • 95017 Allergy testing, any combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal), sequential and incremental, with venoms, immediate type reaction, including test interpretation and report, specify number of tests
  • 95018 Allergy testing, any combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal), sequential and incremental, with drugs or biologicals, immediate type reaction, including test interpretation and report, specify number of tests
  • 95024 Intracutaneous (intradermal) tests with allergenic extracts, immediate type reaction, including test interpretation and report, specify number of tests
  • 95027 Intracutaneous (intradermal) tests, sequential and incremental, with allergenic extracts for airborne allergens, immediate type reaction, including test interpretation and report, specify number of tests
  • 95028 Intracutaneous (intradermal) tests with allergenic extracts, delayed type reaction, including reading, specify number of tests
  • 95044 Patch or application test(s) (specify number of tests)
  • 95052 Photo patch test(s) (specify number of tests)
  • 95056 Photo tests
  • 95060 Ophthalmic mucous membrane tests
  • 95065 Direct nasal mucous membrane test
  • 95199 Unlisted allergy/clinical immunologic service or procedure
  • 0165U Peanut allergy-specific quantitative assessment of multiple epitopes using enzyme-linked immunboabsorbant assay (ELISA), blood, individual epitope results and probability of peanut allergy
  • 0178U Peanut allergen-specific quantitative assessment of multiple epitopes using enzyme-linked immunosorbent assay (ELISA), blood, report of minimum eliciting exposure for a clinical reaction



Selected References:

  • U.S. Food and Drug Administration (FDA) Compliance Policy Guidelines  Section 370.100; Cytotoxic Testing for Allergic Diseases(CPG 7124.27).
  • American Academy of Allergy: Position Statements-Controversial techniques. Journal of Allergy and Clinical Immunology 67:333-338 1980. Reaffirmed 2012.
  • Sicherer, SH. Manifestations of food allergy: Evaluation and management. American Family Physician 59:415-424, 1999
  • Boyles JH Jr. A comparison of techniques for evaluating IgE-mediated allergies. Ear Nose Throat J. 2011 Apr; 90(4):164-9.
  • Bernstein IL, Li JT, Bernstein DI et al. Allergy diagnostic testing: an updated practice parameter. Part 1. Ann Allergy Asthma Immunol 2008 Mar; 100(3 Suppl 3):S15-S66. 
  • ECRI Institute. [Product Overview] Complement Antigen Technology for Testing Food Sensitivity. 02/13/2013.
  • Adkinson: Middleton’s Allergy: Principles and practice, 8th ed. Saunders, an inmrint of Elsevier, 2013.
  • Boyce JA. National institute of allergy and infectious diseases: Guidelines for the diagnosis and management of food allergy in the United States: summary of the NIAID sponsored expert panel report. Nutr Res. 2011 Jan; 31(1):61-75.
  • Chafen JJ, Newberry SJ, Riedl MA, Bravata DM, Maglione M, Suttorp MJ et al. Diagnosing and managing common food allergies: a systematic review. JAMA 2010;303:1848–1856.
  • Keet CA, Wood RA, Matsui EC. Limitations of reliance on specific IgE for epidemiologic surveillance of food allergy. J Allergy Clin Immunol 2012;130:1207–1209.
  • Muraro A, Roberts G, Worm M, Bilò M, Brockow K, Fernández-Rivas M et al. Anaphylaxis: guideline from the European Academy of Allergology and Clinical Immunology. Allergy 2014; doi: 10.1111/all.12437.
  • Liao W, Hu Q, Shen LL, et al. Sublingual immunotherapy for asthmatic children sensitized to house dust mite: A meta-analysis. Medicine (Baltimore). 2015;94(24):e701.
  • Makela M, Jartti T, Kolho KL, et al. Update on current care guideline: Food allergy (children). Duodecim. 2015;131(7):694-695.
  • Seidman MD, Gurgel RK, Lin SY, et al; Guideline Otolaryngology Development Group. AAO-HNSF. Clinical practice guideline: Allergic rhinitis. Otolaryngol Head Neck Surg. 2015;152(1 Suppl):S1-S43.
  • Pfaar O, Demoly P, Gerth van Wijk R, et al; European Academy of Allergy and Clinical Immunology. Recommendations for the standardization of clinical outcomes used in allergen immunotherapy trials for allergic rhinoconjunctivitis: An EAACI Position Paper. Allergy. 2014;69(7):854-867.
  • American Academy of Allergy, Asthma, & Immunology. Choosing Wisely Released April 4, 2012 (1-5) and March 3, 2014 (6-10).
  • Fonacier L et al. Contact dermatitis: a practice parameter update 2015. Journal of Allergy Clinical  Immunology Practice 2015;3(3 Suppl):S1–39.
  • Chen, Jennifer K. MD; Jacob, Sharon E. MD; Nedorost, Susan T. MD; Hanifin, (2016). A Pragmatic Approach to Patch Testing Atopic Dermatitis Patients: Clinical Recommendations Based on Expert Consensus Opinion. Dermatitis (27), 186-192.
  • Togias et al. Addendum guidelines for the prevention of peanut allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases-sponsored expert panel. Journal of Allergy and Clinical Immunology DOI: 10.1016/j.jaci.2016.10.010 (2017).
  • Siles RI and Hsieh FH. Allergy blood testing: A practical guide for clinicians. Cleve. Clin. J. Med. 2011;78(9):585-592.
  • National Institute of Clnical Excellus: Testing and referring for food allergy in under 19s NICE Pathway last updated: 10 October 2018.
  • Kowalski ML, Ansotegui I, Aberer W, et al. Risk and safety requirements for diagnostic and therapeutic procedures in allergology: World Allergy Organization Statement. World Allergy Organ J. 2016;9(1):33. Published 2016 Oct 12. doi:10.1186/s40413-016-0122-3  
  • Agyemang, Amanda et al. (2019). A novel approach to the Basophil Activation Test (BAT) for characterizing peanut allergic patients in the clinical setting. Journal of Allergy and Clinical Immunology, Volume 143(2), doi: 10.1016/j.jaci.2018.12.812 
  • Wilson, Jeffrey M. et al. IgE to galactose-α-1,3-galactose and the α-Gal syndrome: Insights from basophil activation testing. Journal of Allergy and Clinical Immunology, Volume 143, Issue 1, 101 – 103. 
  • Wong AG, Lomas JM, Allergy Testing and Immunotherapy. Pediatr Rev. 2019 May;40(5):219-228. doi: 10.1542/pir.2018-0126.
  • Kowal, K., & DuBuske, L. (2020). Overview of skin testing for allergic disease - UpToDate. UpToDate.
  • Hamilton, R. (2020). Allergen sampling in the environment - UpToDate. In A. Feldweg (Ed.), UpToDate.
  • Ansotegui, I. J., Melioli, G., Canonica, G. W., Caraballo, L., Villa, E., Ebisawa, M., . . . Zuberbier, T. (2020). IgE allergy diagnostics and other relevant tests in allergy, a World Allergy Organization position paper. World Allergy Organ J, 13(2), 100080. doi:10.1016/j.waojou.2019.100080


Policy History:

  • February 2021 - Annual Review, Policy Revised
  • February 2020 - Annual Review, Policy Revised
  • February 2019 - Annual Review, Policy Revised
  • February 2018 - Annual Review, Policy Revised
  • February 2017 - Annual Review, Policy Revised
  • April 2016 - Annual Review, Policy Revised
  • May 2015 - Annual Review, Policy Revised
  • June 2014 - Annual Review, Policy Revised
  • August 2013 - Annual Review, Policy Revised
  • September 2012 - Annual Review, Policy Revised
  • September 2011 - Annual Review, Policy Renewed

Wellmark medical policies address the complex issue of technology assessment of new and emerging treatments, devices, drugs, etc.   They are developed to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. Wellmark medical policies contain only a partial, general description of plan or program benefits and do not constitute a contract. Wellmark does not provide health care services and, therefore, cannot guarantee any results or outcomes. Participating providers are independent contractors in private practice and are neither employees nor agents of Wellmark or its affiliates. Treating providers are solely responsible for medical advice and treatment of members. Our medical policies may be updated and therefore are subject to change without notice.


*CPT® is a registered trademark of the American Medical Association.