Otolaryngology Coding Alert

Reader Questions:

Assess Which Allergic Rhinitis Code Fits the Bill

Published on Wed May 10, 2023

Question: A patient presents with a runny nose, watery eyes, and sneezing. The otolaryngologist documents hay fever and determines the patient has seasonal allergies and deduces pollen as the allergen. How should I report the diagnosis?

Arizona Subscriber

Answer: You can find many allergy-related conditions within the J30.- codes (Vasomotor and allergic rhinitis). For this scenario, resist the temptation to report J30.2 (Other seasonal allergic rhinitis). Even though the provider documented seasonal allergies, J30.1 (Allergic rhinitis due to pollen) is more appropriate.

Here’s why: While seasonal rhinitis is common in spring, and even summer and early fall, the causes are typically airborne mold spores, dust mites, or pollens from grass, trees, and weeds. A quick look at the Alphabetic Index will tell you why J30.1 is the better choice. The ICD-10 index entry for hay fever refers you to J30.1. Additionally, “hay fever” is listed as one of the synonyms for J30.1.

Bottom line: You would report J30.2 if airborne mold spores or dust mites cause the rhinitis; whereas you would report J30.1 for hay fever, as the code specifically cites pollen as the cause.