CPT® Code 86008

Official Description

Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each

Common Language Description

The CPT® Code 86008 refers to a laboratory test that measures allergen-specific immunoglobulin E (IgE) levels in the blood. This test is commonly known as the radioallergosorbent test (RAST) and is classified as an in vitro test, meaning it is conducted outside of a living organism, specifically using blood samples. Unlike skin tests, which are performed directly on the skin (in vivo), this blood test quantifies or semi-quantifies the presence of IgE antibodies that are associated with various allergic reactions. The results are expressed in IgE units, which are interpreted through a scoring system to determine the severity of the allergy. The test is designed to identify a broad spectrum of IgE immunoglobulins, which are antibodies that play a crucial role in allergic responses. These antibodies can be triggered by a variety of allergens, including food items, animal dander, dust mites, molds, and various types of plants such as grasses, trees, and weeds, as well as insect stings. Advances in allergy testing technology have enhanced the ability to detect even low levels of allergen proteins, thereby improving the identification of specific allergies. Typically, the test is performed as part of an allergy panel or profile, which may include multiple allergens relevant to a specific geographic area or demographic group, such as adults or children. These panels can encompass a wide range of common allergens, often numbering a dozen or more. Examples of such panels include the upper respiratory allergy profile, adult food allergy profile, child food allergy profile, and child environmental allergy profile. It is important to note that other related codes exist, such as CPT® Code 86003, which is used for each crude allergen extract tested using a quantitative or semiquantitative method, and CPT® Code 86005, which is applicable for qualitative multiallergen screening tests that determine the presence or absence of specific IgE without providing quantitative measurements.

1. Indications

The allergen-specific IgE test (CPT® Code 86008) is indicated for the evaluation of patients who exhibit symptoms suggestive of allergic reactions. This test is particularly useful in the following scenarios:

Allergic Rhinitis Patients presenting with symptoms such as sneezing, nasal congestion, and itchy eyes may undergo this test to identify specific allergens triggering their symptoms.
Food Allergies Individuals experiencing adverse reactions after consuming certain foods can be tested to determine specific food allergens responsible for their symptoms.
Atopic Dermatitis Patients with chronic skin conditions characterized by inflammation and itching may benefit from this test to identify potential allergenic triggers.
Asthma Patients with asthma may be tested to identify environmental or food allergens that could exacerbate their condition.
Insect Allergies Individuals with a history of allergic reactions to insect stings or bites may be evaluated to identify specific insect allergens.

2. Procedure

The procedure for conducting the allergen-specific IgE test involves several key steps, which are outlined below:

Step 1: Sample Collection A blood sample is collected from the patient, typically via venipuncture. This sample serves as the basis for the allergen-specific IgE testing.
Step 2: Laboratory Processing The collected blood sample is sent to a laboratory where it undergoes processing. This may involve separating the serum from the blood cells to isolate the IgE antibodies present in the serum.
Step 3: Allergen Exposure The serum is then exposed to various allergens, either in a quantitative or semiquantitative manner. This exposure allows for the binding of specific IgE antibodies to the corresponding allergens.
Step 4: Measurement The laboratory measures the levels of IgE antibodies that bind to the allergens. The results are reported in IgE units, which can be interpreted using a scoring system to assess the severity of the allergic response.
Step 5: Result Interpretation The final results are compiled and interpreted by a qualified healthcare professional, who will assess the levels of specific IgE antibodies to determine the patient's allergic sensitivities.

3. Post-Procedure

After the allergen-specific IgE test is completed, patients may not require any specific post-procedure care, as the test is non-invasive and involves only a blood draw. However, it is essential for healthcare providers to discuss the results with the patient, explaining the significance of the IgE levels and how they relate to the patient's symptoms. Based on the findings, further management strategies may be recommended, which could include avoidance of identified allergens, additional testing, or treatment options such as allergy medications or immunotherapy. Patients should be advised to follow up with their healthcare provider to discuss the results and any necessary next steps in their allergy management plan.

Short Descr	ALLG SPEC IGE RECOMB EA
Medium Descr	ALLERGEN SPEC IGE RECOMBINANT/PURIFIED COMPNT EA
Long Descr	Allergen specific IgE; quantitative or semiquantitative, recombinant or purified component, each
Status Code	Statutory Exclusion (from MPFS, may be paid under other methodologies)
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	9 - Not Applicable
Multiple Procedures (51)	9 - Concept does not apply.
Bilateral Surgery (50)	9 - Concept does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	9 - Concept does not apply.
Co-Surgeons (62)	9 - Concept does not apply.
Team Surgery (66)	9 - Concept does not apply.
Diagnostic Imaging Family	99 - Concept Does Not Apply
CLIA Waived (QW)	No
APC Status Indicator	Conditionally packaged laboratory tests
Type of Service (TOS)	5 - Diagnostic Laboratory
Berenson-Eggers TOS (BETOS)	none
MUE	20

59	Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
90	Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number.
XU	Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
GA	Waiver of liability statement issued as required by payer policy, individual case
GZ	Item or service expected to be denied as not reasonable and necessary
91	Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient.
XS	Separate structure, a service that is distinct because it was performed on a separate organ/structure
51	Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
GW	Service not related to the hospice patient's terminal condition