Publication Number

100-3

Manual Section Number

30.6

Version Number

1

Effective Date of this Version

This is a longstanding national coverage determination. The effective date of this version has not been posted.

Benefit Category

Physicians' Services

Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.

Item/Service Description

The only accepted and scientifically valid medical use of histamine is diagnostic, including tests to assess:

• The ability of the stomach to secrete acid;
• The integrity of peripheral sensory nerves (e.g., in leprosy);
• The circulatory competency in limb extremities; and
• The presence of a pheochromocytoma.

Indications and Limitations of Coverage

However, there is no scientifically valid clinical evidence that histamine therapy is effective for any condition regardless of the method of administration, nor is it accepted or widely used by the medical profession. Therefore, histamine therapy cannot be considered reasonable and necessary, and program payment for such therapy is not made.

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Page Last Modified: 4/23/2009 7:26:58 AM

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