The performing laboratory must document that the patient meets the approved indications and supply that information as a billing note record.
The standard number of allowable allergen specific 1gE antibodies per 12 month period is 5 per patient.
This number can be increased to 10 when further approved by a laboratory physician. (This will require the addition of the billing number of the approving laboratory physician to the note record.
If the ordering physician is an allergy specialist (as approved by the Section of Clinical Immunology and Allergy) the number of allowable tests per 12 month period can exceed the allowable number specified in 2 or 3, up to 20. A note record is required beyond 20. (See the Protocol under the Chemistry Guidelines in the Laboratory Medicine Preamble.)
Please reference the billing pre-amble for these relevant interpretations of this billing code:See Pre-Amble Notes