With allergy coding, the use of T codes-especially anaphylactic response is being used liberally whenever a patient is receiving follow up care such as cluster injections or Epipen refill, and the initial/only anaphylactic response was often times years ago- would it be appropriate to change to a "history of" Z code instead, or due to "actively" treating the allergy with maintenance allergy shots (95115,95117,95165), ingestion challenge (95076/95079), or rapid desensitization/cluster injections (95180), it would remain a T code with 7th character "A"- or should it be "D"? Example: T78.01XA/D or Z91.010 for peanut allergy that is not acutely treated at time of visit. Thank you!
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Wiki Allergy Diagnosis coding
- Thread starter Tammy.Hayden@DignityHealth.org
- Start date
rthomas@impcna.com
Expert
We are a PCP office and we have patients that have their allergist send their allergy injection serum for us to administer (95115 or 95117). The allergist that we do this for recommended that we use T78.49XD. We have never had an issue with reimbursement.
I usually recommend avoiding the T code series for any allergy that is not causing an immediate reaction. The Z codes for allergies are NOT history codes. These are STATUS codes, and it is important to note the difference. The patient has an allergy status, and thus is being treated to reduce the intensity of any future reaction. Unless, of course, the treatment results in a reaction - at that point it goes from a status to an acute illness and the T codes would be appropriate.