Order Code
5489
Preferred Specimen
Collect 4 mL of serum in an SST tube. Allow the sample to clot upright for at least 30 minutes, then centrifuge it within 2 hours after collection. Store the specimen refrigerated.
Note: When requesting multiple IgE specific allergen tests, the following specimen volumes are recommended:
For 25–40 allergens: ≥ 3–4 mL of serum
For 2–24 allergens: ≥ 2 mL of serum
ContainerType
Serum separator tube
Alternate Specimen Requirements
Collect 4 mL of serum using a plain red-top tube. Permit the sample to clot upright for at least 60 minutes, then centrifuge and transfer the serum into a plastic transport tube within 2 hours of collection. Clearly label the tube as serum from a plain red top tube. Refrigerate.
Note: For multiple IgE specific allergen testing, recommended serum volumes are the same as above:
25–40 allergens: minimum 3–4 mL
2–24 allergens: minimum 2 mL
Minimum Volume
4 mL serum
Transport Temperature
Refrigerated
Specimen Stability
1 day room temperature; 1 week refrigerated;
1 month frozen
Methodology
Immunocap fluoroenzymeimmunoassay (FEIA)
Rejection Criteria
- Avoid repeated freeze/thaw cycles
Test Setup Days
Monday through Friday
CPT
86003 X5 IgE Allergen Testing Is Limited As Follows:
Florida – Medicare Limited To 30 Allergens Per Year.
Medicaid Limited To 12 Allergens Per Year.
Kentucky – Medicare Limited To 30 Allergens Per Year.
Ohio – Medicare Limited To 30 Allergens Per Year.
Oklahoma – Medicaid Prior Authorization Is
Required.
Texas – Limited Coverage Test For Medicare.
Advance Beneficiary Notice Of
Non-Coverage (ABN) Required If
Diagnosis Not Covered.
Frequency Limit Test For Medicare.
Advance Beneficiary Notice Of
Non-Coverage (ABN) Always Required For
Frequency.
Medicaid Limited To 30 Allergens Per
Year.