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6.3.2.2.1 RAST/MAST Tests
Radioallergosorbent tests (RAST) and multiple antigen simultaneous tests (MAST) are benefits of Texas Medicaid. RAST testing is a radioimmunoassay of the blood serum used to detect specific allergens. MAST is an RAST type test using an enzyme rather than a radioactive marker. RAST/MAST testing is usually performed by an independent lab; however, there are physicians who have the capability of performing these tests in their offices. Physicians who submit RAST/MAST tests performed in the office setting must use modifier SU to be considered for reimbursement. Without the use of the SU modifier, RAST/MAST testing submitted with POS 1 (office) is denied with the message, "Lab performed outside of office must be billed by the performing facility."
RAST/MAST tests should be submitted using procedure codes 86003 and 86005.
Procedure code 86003 should be submitted with a quantity of 1 and is limited to 12 per year, same provider.
Procedure code 86005 should be submitted with a quantity of one and is limited to four per year, same provider.
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