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Documenting Food Allergies with ICD-10 Codes

by | Jan 19, 2017 | Medical Coding News, Resources | 0 comments

Different food items and special dishes play a key role in any celebrations; let that be Christmas dinner, New Year’s Eve, or even a birthday party. But for people who have food allergies, such occasions may not be very enjoyable. According to a report from the Food Allergy Research & Education (FARE), approximately 15 million Americans have food allergies and this potentially deadly condition affects 1 in every 13 children. Despite the risk of severe allergic reactions, there is no current treatment for food allergy. The disease can only be managed by allergen avoidance or treatment of symptoms.

The common foods that can cause an allergy are eggs, peanuts, fish, shellfish, tree nuts, milk, wheat, and soy. Signs and symptoms that can develop within a few minutes to an hour after eating the food may include swelling of the lips, face, tongue, and throat, nasal congestion, breathing difficulties, abdominal pain or cramps, diarrhea, nausea and vomiting. Proven diagnosis tests include Skin prick test, Blood test, Oral food challenge or Trial elimination diet. Depending on your medical history and initial test results, you may have to take more than one test before receiving your diagnosis.

Allergists point out that patients with allergies should have an action plan for any severe allergic reactions. While allergy status is where patient has a known allergy to a food or substance, an allergic reaction is where patient is having a current reaction to a substance/food item. It is important that the physician or allergist treating the condition is documenting it specific to the circumstances and cause, to ensure accurate code assignment.

Allergy and sleep medicine coding is challenging due to this specialty’s dynamics. While some insurance companies treat allergy testing and serum reimbursements differently, others distinguish between the build-up and maintenance doses of medication. ICD-10 codes for food allergy include:

  • Z91.012 – Allergy to eggs
  • Z91.010 – Allergy to peanuts
  • Z91.011 – Allergy to milk products
  • Z91.013 – Allergy to seafood
  • Z91.018 – Allergy to other foods

Anaphylaxis – a Severe, Potentially Fatal Allergic Reaction

A reaction to food can range from a mild response (such as an itchy mouth) to anaphylaxis, a severe and potentially deadly reaction. Anaphylaxis often begins within minutes after a person eats a problem food. In certain cases, allergists prescribe epinephrine. Keep in mind that epinephrine expires after a certain period (usually around one year), so be sure to check the expiration date and renew your prescription in time.

Skilled medical coders stay up-to-date with the relevant ICD-10 codes to document such anaphylactic reactions such as –

  • T78.0 – Anaphylactic reaction due to food
  • T80.5 – Anaphylactic reaction due to serum
  • T78.00XA – Anaphylactic reaction due to unspecified food, initial encounter
  • T78.02XA – Anaphylactic reaction due to shellfish (crustaceans), initial encounter
  • T78.03XA – Anaphylactic reaction due to other fish, initial encounter
  • T78.04XA – Anaphylactic reaction due to fruits and vegetables, initial encounter
  • T78.05XA – Anaphylactic reaction due to tree nuts and seeds, initial encounter
  • T78.07XA – Anaphylactic reaction due to milk and dairy products, initial encounter
  • T78.08XA – Anaphylactic reaction due to eggs, initial encounter
  • T78.09XA – Anaphylactic reaction due to other food products, initial encounter

However, anaphylaxis is unpredictable for one with a food allergy. A person who previously had only mild reactions can have a life-threatening reaction, while someone with a history of anaphylaxis may have a mild reaction.

Medical Coding Outsourcing is an ideal option for diagnostic centers and allergy care centers. Reliable service providers help them overcome claim submission challenges and receive maximum reimbursement for services rendered.