Internal Medicine Coding Alert

Question: What do you recommend as the most specific E code for anaphylaxis reaction to peanut butter?

Arizona Subscriber

Answer: To report anaphylaxis reaction to peanut butter, start with a code from family 995.x (Certain adverse effects not elsewhere classified). Of these, the closest fit will be 995.61 (Anaphylactic reaction due to peanuts).

For injury and poisoning codes (800-999), ICD-9 sometimes encourages reporting an E code to indicate the cause and intent of the injury or poisoning. There is no such direction specific to 995.61, which is already explicit about the cause of the anaphylactic reaction. However, if you wanted to report an E code in addition to 995.61, then your best bet is E865.8 (Accidental poisoning from poisonous foodstuffs and poisonous plants; other specified foods). By reporting this code, you are, in essence, stating that peanut butter is "poisonous" to this particular patient, as evidenced by the anaphylactic reaction, and that the incident in question was accidental (i.e., there was no intent by the patient or anyone else to harm the patient).