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Intracutaneous (intradermal) tests, sequential and incremental, with allergenic extracts for airborne allergens, immediate type reaction, including test interpretation and report, specify number of tests

CPT4 code

Name of the Procedure:

Intracutaneous (Intradermal) Tests for Airborne Allergens

Summary

Intracutaneous (intradermal) tests involve injecting small amounts of allergenic extracts just under the skin to identify allergic reactions to airborne substances, such as pollen, dust mites, and mold. These tests help determine if a person has immediate hypersensitivity to specific allergens. The procedure also includes interpretation and a detailed report of the results.

Purpose

The main aim is to diagnose allergies to airborne allergens. Identifying specific allergens helps in managing and treating allergic conditions, improving patient quality of life and reducing symptoms.

Indications

  • Persistent or unexplained respiratory symptoms such as sneezing, coughing, wheezing, or nasal congestion.
  • Suspected hay fever (allergic rhinitis) or asthma.
  • Previous inconclusive allergy tests.
  • Patients with a history of allergic reactions where the allergen is unidentified.

Preparation

  • Discontinue antihistamines and certain other medications as advised by the healthcare provider.
  • Avoid applying lotions or creams to the test site on the day of the procedure.
  • Notify the healthcare provider of all medications and supplements being taken.

Procedure Description

  1. The patient is seated comfortably, and the test area (usually the forearm) is cleaned.
  2. Small amounts of allergenic extracts are injected just under the skin using a fine needle.
  3. Each injection site is labeled for identification.
  4. The patient waits about 15-20 minutes for the skin reaction.
  5. The healthcare provider then measures and records the size and nature of any reactions.
  6. Results are interpreted, and a report is provided, including a detailed analysis.

Duration

Approximately 30-60 minutes.

Setting

Outpatient clinic or specialized allergy testing center.

Personnel

  • Allergist or immunologist
  • Trained nurse or medical assistant

Risks and Complications

  • Mild pain or discomfort at the injection sites.
  • Itching or redness at the test sites.
  • Rarely, more severe allergic reactions (e.g., anaphylaxis), requiring immediate medical intervention.

Benefits

  • Accurate identification of specific airborne allergens.
  • Enhanced ability to manage and treat allergy symptoms.
  • Personalized treatment plans, including avoidance measures and specific medications.

Recovery

  • Patients can typically resume normal activities immediately after the procedure.
  • Follow-up appointment may be scheduled to discuss results and treatment plans.

Alternatives

  • Skin prick tests: Less invasive and quicker but might be less sensitive.
  • Blood tests (e.g., specific IgE tests): Useful for patients with skin conditions or those who cannot discontinue medications. Less immediate feedback compared to skin tests.

Patient Experience

  • Patients may feel a slight pricking sensation during the injections.
  • Mild itching or redness may occur at the test sites, which usually subsides within a few hours.
  • Pain management typically not necessary, but cool compresses or antihistamines might be recommended for discomfort.

Medical Policies and Guidelines for Intracutaneous (intradermal) tests, sequential and incremental, with allergenic extracts for airborne allergens, immediate type reaction, including test interpretation and report, specify number of tests

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