CommercialCoverageMedium impact
Allergy Testing 2.01.10
Excellus BlueCross BlueShield·Allergy & Immunology, ENT (Ear, Nose & Throat), Dermatology +1 more·Ear, Nose & Throat (Otorhinolaryngology)
Effective date
Jul 17, 2025
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield has established a comprehensive allergy testing policy effective July 17, 2025, defining which allergy tests are considered medically appropriate versus investigational. The policy specifies criteria for allergen-specific IgE testing and lists several testing methods as investigational and not covered.
Action Required
Before July 17, 2025: Billing team must review all allergy testing procedures to ensure compliance with new Excellus BCBS policy 2.01.10. Update billing system to flag investigational tests (allergen-specific IgG, leukocyte histamine release, ophthalmic mucous membrane tests, direct nasal mucous membrane tests, peanut allergen ELISA, cytotoxicity/provocative testing) for potential claim denials. Ensure allergen-specific IgE testing meets one of the nine specified criteria before billing. Train providers on documentation requirements for covered allergy testing scenarios.