decisionhealth Newsletters, Part B News - 2026 Issue 9 (September)
Nothing to sneeze at: Prep for new allergy testing LCD finalized by 5 MACs
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Article Overview
The article reviews a uniform allergy diagnostic testing policy issued by five Medicare administrative contractors, including its effective dates and the types of practices and services it concerns. It covers provider qualifications and readiness, terminology used for common allergy testing methods, medical necessity and documentation, and utilization considerations. The intended audience includes allergy-testing practices, clinicians, and coding and billing staff preparing for the policy.
Why This Topic Matters
The policy affects allergy diagnostic testing in multiple states and addresses clinical readiness, documentation, and utilization—areas relevant to practices and staff responsible for Medicare Part B services.
Article Sections
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Check provider, practice readiness
This section discusses provider qualifications, clinical staff oversight, and practice preparedness for allergy testing.
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Teach the LCD’s language
This section introduces terminology associated with several commonly reported allergy testing methods.
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Monitor medical necessity and documentation
This section covers medical necessity and documentation topics addressed by the policy, including clinical records and testing results.
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Explain utilization limits
This section surveys the policy’s utilization considerations and their relationship to published professional standards and claim edits.
What You Will Learn
- Which Medicare administrative contractors issued the policy and when it takes effect.
- What provider readiness and clinical oversight topics the policy addresses.
- Which allergy testing methods and terminology the article discusses.
- What medical necessity and documentation topics are included.
- What utilization considerations and claim-edit topics are covered.
Who Should Read This
- Allergy-testing practices
- Allergy and immunology clinicians
- Clinical staff involved in allergy testing
- Medical coders and billing staff
- Medicare Part B providers
Codes Discussed
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