Food Allergy Profile with Reflexes

Test Code

91682

CPT Codes
86003 (x15)

Includes

IgE allergy testing for:
Almond (f20)
Cashew Nut (f202)
Codfish (f3)
Cow's Milk (f2)
Egg White (f1)
Hazelnut (f17)
Peanut (f13)
Salmon (f41)
Scallop (f338)
Sesame Seed (f10)
Shrimp (f24)
Soybean (f14)
Tuna (f40)
Walnut (f256)
Wheat (f4)

If Cow's Milk (f2) IgE is ≥0.10 kU/L, then Milk Component Panel will be performed at an additional charge (CPT code(s): 86008 x3).
Milk Component Panel includes Alpha-lactalbumin (f76) IgE, Beta-lactoglobulin (f77) IgE, and Casein (f78) IgE.|

If Egg White (f1) IgE is ≥0.10 kU/L, then Egg Component Panel will be performed at an additional charge (CPT code(s): 86008 x2).
Egg Component Panel includes Ovalbumin (f232) IgE and Ovomucoid (f233) IgE.

If Peanut (f13) IgE is ≥0.10 kU/L, then Peanut Component Panel will be performed at an additional charge (CPT code(s): 86008 x6).
Peanut Component Panel includes Ara h 1 (f422), Ara h 2 (f423), Ara h 3 (f424), Ara h 6 (f447), Ara h 8 (f352), and Ara h 9 (f427).

Preferred Specimen

2.5 mL serum

Minimum Volume

1.5 mL

Transport Temperature

Room temperature

Specimen Stability

Room temperature: 14 days
Refrigerated: 14 days
Frozen: 30 days

Methodology
Immunoassay (IA)

Setup Schedule

Set up: Mon-Sat; Report available: 1-3 days

Clinical Significance

This in vitro allergen-specific IgE panel is used to quantitatively measure an individual's IgE response to 15 different foods that are commonly associated with allergies. These foods include almond, cashew nut, codfish, cow's milk, egg white, hazelnut, peanut, salmon, scallop, sesame seed, shrimp, soybean, tuna, walnut, and wheat. If the IgE result for egg white, cow's milk, or peanut is abnormal, the corresponding allergen component panel will be performed. This IgE panel is intended to be used in conjunction with other clinical information to aid in the diagnosis of food allergies [1].

While allergen-specific serum IgE testing is considered comparable to skin testing in many instances, both the American Academy of Allergy, Asthma, and Immunology and the American College of Allergy, Asthma, and Immunology recognize that allergen-specific serum IgE testing may be preferred in some clinical situations. These include (1) the presence of widespread skin disease, (2) the recent use of antihistamines or other medications that can affect the results of allergy skin tests, (3) uncooperative patients, and (4) medical history suggesting that allergen skin testing would pose a significant risk for a serious allergic reaction [1].

Food-specific IgE tests are extremely sensitive. However, a positive test result only indicates that a patient is IgE-sensitized to the food of concern. Many IgE-sensitized individuals do not develop any symptoms when the food is ingested. A diagnosis of food allergy should only be made by a trained medical provider after conducting a thorough clinical evaluation [2,3]. While food-specific IgE test results may contribute to that evaluation, they cannot replace it. Moreover, several forms of food hypersensitivity are not associated with the presence of food-specific IgE in serum.

The results of this panel should be interpreted in the context of pertinent clinical and family history and physical examination findings. More specific information about each allergen included in this panel may be found on the Quest Diagnostics Test Directory.

⁠⁠⁠⁠⁠⁠⁠References
1. Bernstein IL, et al. Ann Allergy Asthma Immunol. 2008;100(3 Suppl 3)S1-S148.
2. Sampson HA, et al. J Allergy Clin Immunol. 2014;134(5):1016-1025.
3. NIAID-Sponsored Expert Panel, Boyce JA, et al. J Allergy Clin Immunol. 2010;126(6 Suppl):S1-S58.

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.