Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction, including test interpretation and report, specify number of tests
CPT4 code
Name of the Procedure:
Percutaneous Tests (Scratch, Puncture, Prick) with Allergenic Extracts, Immediate Type Reaction, including Test Interpretation and Report
Summary
Percutaneous allergy tests involve applying small amounts of allergens to the skin and observing for an immediate allergic reaction. The tests, including scratch, puncture, and prick methods, help determine specific allergies by causing a controlled allergic response.
Purpose
This procedure addresses allergic conditions like hay fever, food allergies, and environmental allergens, allowing for the identification of specific allergens to which the patient is sensitive. The goal is to guide patients in avoiding allergens and to assist healthcare providers in planning appropriate treatments or interventions.
Indications
- Symptoms of seasonal allergies (e.g., itchy eyes, sneezing)
- Unexplained rashes or hives
- Allergic asthma
- Anaphylactic episodes
- Suspected food allergies
- Patient history suggests allergy-related issues
Preparation
- Discontinue antihistamines and certain medications at least 48-72 hours before the test.
- Inform the provider of all medications, supplements, and herbal remedies being taken.
- No need for fasting.
- Ensure skin is clean and free from lotions or topical medications on the day of the test.
Procedure Description
- The procedure typically starts with the clinician reviewing the patient's clinical history and explaining the test.
- The patient's forearm or back is cleaned with alcohol.
- Allergenic extract is applied to the skin using scratch, puncture, or prick method.
- Scratch Test: Skin is lightly scratched with a sterile tool.
- Puncture Test: A small lancet punctures the top layer of skin.
- Prick Test: A tiny needle pricks the skin surface.
- Each allergen site is marked and observed for 15-20 minutes.
- The reactions are measured and interpreted based on wheal (raised bump) and erythema (redness).
Duration
The entire procedure, including observation and interpretation, typically takes about 30-40 minutes.
Setting
The procedure is usually performed in a doctor's office, outpatient clinic, or allergist's office.
Personnel
- Allergist or immunologist
- Trained nurse or medical assistant
Risks and Complications
- Mild itching and swelling at test sites
- Rarely, a more widespread allergic reaction (anaphylaxis) which is managed with immediate medical intervention.
Benefits
- Identification of specific allergens causing symptoms.
- Enables tailored avoidance strategies and treatment plans.
- Results are available within minutes.
Recovery
- Minimal recovery time is needed.
- Post-procedure care includes avoiding scratching test sites and applying antihistamines or topical creams if irritation occurs.
- Normal activities can be resumed immediately unless advised otherwise.
Alternatives
- Blood tests (e.g., Specific IgE tests) to identify allergens.
- Avoidance and observation of symptoms strategy.
- Each alternative has its pros and cons regarding accuracy, time, and potential discomfort.
Patient Experience
During the procedure, patients might experience minor discomfort from needle pricks or scratches. Redness and swelling at test sites are common but usually resolve quickly. Post-test itching can be managed with cold compresses or medications as recommended by the healthcare provider.