Pediatric Coding Alert

Question: Our pediatrician saw a new patient for a wellness visit and wrote that she has an underlying condition called extrinsic allergic alveolitis. I cannot find this on our list of common allergens—which diagnosis codes should we use?

South Carolina subscriber

Answer:  Most allergy patients your pediatrician sees in the springtime might be treated for seasonal conditions, but extrinsic allergic alveolitis, or EAA, is a completely different situation. Patients with EAA have lung and airway inflammation because of repeated inhalation of organic antigens in dusts (such as from dairy or grain products or animal dander). Another name for EAA is hypersensitivity pneumonitis. Acute and subacute forms of EAA can cause recurrent pneumonitis; chronic disease can cause fibrosis, emphysema, and permanent lung damage. This is more common in adult patients who inhale dusts at their place of work, but it can happen with children who are exposed to mold or other inhalants.

To code this, you’ll turn to the 495.x series (Extrinsic allergic alveolitis), most often with either 495.9 (Unspecified allergic alveolitis and pneumonitis) or 495.8 (Other specified allergic alveolitis and pneumonitis) if the pediatrician knows the specific type.

Under ICD-10, these will break out to J67.x (Extrinsic allergic alveolitis), which include codes such as J67.8 (Hypersensitivity pneumonitis due to other organic dusts) and J67.9 (Hypersensitivity pneumonitis due to unspecified organic dust), among others.