Wiki 95117 with V07.1

[kellywilder]

A patient's plan is denying her allergy shots with the diagnosis V07.1. We are being asked to change to 477.0. However, during the patient's appointment it was not notated whether or not she was suffering from her allergies at the time. I'm not sure we are able to change the code since symptoms weren't noted. Thoughts?

 

[mitchellde]

v07.1 is the correct DX code since the reason for the shot is the need to desensitize. Many plans do not pay for routine prophylactic allergy shots. Most pay only to lessen an acute allergic response.