Pulmonology Coding Alert

Question: What ICD-9 code is used for a patient who is coming to the office to receive routine allergy shots for multiple allergies? Should we be specific with ICD-9 as to the type of allergies? Although the patient is free from symptoms, the shots are to prevent allergic symptoms to grass, ragweed, etc. History codes are generally denied.

New Jersey Subscriber

Answer: You should use the appropriate allergy code first and V07.1 (Desensitization to allergens) as a secondary code. The pulmonologist administers the immunotherapy because the allergen affects the patient's health. Using the allergy code first will tell the payer why the patient needs immunotherapy.

For instance, a patient receives immunotherapy for dust, cats and pollen. Allergies are considered chronic conditions the condition still exists even though the patient is not having acute symptoms. You should report the appropriate diagnosis for each allergy. For the dust and cat dander, use 477.8 (Allergic rhinitis; due to other allergen). For the pollen allergy, assign 477.0 (... due to pollen). List V07.1 last.