Regarded as one of the most chronic conditions worldwide, allergies occur when your immune system reacts to a foreign substance – such as pollen, bee venom molds, animal dander, latex, insect stings or even certain food items. Generally, an allergic reaction begins in the immune system – which protects our body from invading organisms that cause illness. If a person suffers an allergy, their immune system mistakes an otherwise harmless substance (called an allergen) as an invader. The immune system overreacts to the allergen by producing substances known as Immunoglobulin E (IgE) antibodies. These IgE antibodies travel to cells that release histamine and other chemicals, causing an allergic reaction that can possibly inflame the skin, sinuses, airways or digestive system. The type and severity of allergies can vary from one person to another and can range from minor irritation to severe and potentially life-threatening allergic reactions. Allergy specialists or other specialists dealing with patients suffering from different allergic conditions must provide adequate treatment and also ensure that the medical coding for this specific disorder is properly done on the medical claims. Outsourcing medical coding services to a reputable billing and coding company can help physicians submit their medical claims without errors.

As per reports from Clevelandclinic.org, about 50 million Americans (1 in 6) experience all types of allergies, including indoor/outdoor allergies, food and drug, latex, insect, skin and eye allergies. Typically, an allergic reaction can trigger symptoms in the nose, lungs, throat, sinuses, ears, lining of the stomach or on the skin. Symptoms can range from mild to severe and can include – rash or hives, itchiness, watery/red eyes, runny nose, swelling and trouble breathing, abdominal pain, cramps, vomiting, diarrhea, dizziness and minor drop in blood pressure. Patients in most cases experience one or more of these symptoms immediately after coming into contact with an allergen. If the symptoms last for more than a week and do not seem to be improving, it is important to consult an allergist or immunologist. For patients who experience minor allergies, diagnosis may begin with a physical exam. The physician may ask questions about the immediate symptoms and evaluate previous medical history. Keeping a record of the symptoms over a period of time can help the allergist correctly identify the exact factors that cause the allergies and suggest proper treatment modalities and lifestyle management strategies that help patients feel better and lead a better-quality life.

Here discussed are the three most common allergic conditions and their related ICD-10 codes –

Allergic Rhinitis – Commonly known as hay fever, this is an allergic response to specific allergens. Reports from the American Academy of Allergy, Asthma & Immunology (AAAAI) say that about 8 percent of adults in the United States suffer from allergic rhinitis of some kind. The condition develops when the body’s immune system is sensitized and overreacts or comes in contact with allergens in the environment and releases histamine (a natural chemical that defends your body from the allergen). The symptoms of allergic rhinitis can vary, depending on the type and severity of your allergies. Common symptoms include – sneezing and coughing, swollen eyes, runny/stuffy nose, itching (mostly eyes, nose, mouth, throat and skin), and hives and dark circles under your eyes. Diagnosis of this condition may begin with a physical exam and analysis of symptoms. One of the most common tests for diagnosis is a skin prick test. In addition, blood test and radioallergosorbent test (RAST) may also be performed. Treatment modalities for the condition involve a combination of medications and home remedies. Other therapies include – immunotherapy or allergy shots and sublingual immunotherapy (SLIT – involves placing a tablet containing a mixture of several allergens under the tongue). ICD-10 codes used for billing allergic rhinitis include: –

  • J30 – Vasomotor and allergic rhinitis
  • J30.0 – Vasomotor rhinitis
  • J30.1 – Allergic rhinitis due to pollen
  • J30.2 – Other seasonal allergic rhinitis
  • J30.5 – Allergic rhinitis due to food
  • J30.8 – Other allergic rhinitis
    • J30.81 – Allergic rhinitis due to animal (cat) (dog) hair and dander
    • J30.89 – Other allergic rhinitis
  • J30.9 – Allergic rhinitis, unspecified

Eczema – More common in children, this is a chronic skin disorder characterized by itchy and red skin. Also known as atopic Dermatitis (AD), the prevalence of childhood AD is 10.7 percent in the United States. The exact cause of AD is unknown. However, the presence of too many inflammatory cells in the skin is one of the main factors that cause this condition. As per reports from the American Academy of Dermatology (AAD), 90 percent of people with AD get it before age 5. The condition may also persist into adolescence and adulthood. Itchy skin that often turns into a red rash is one of the primary symptoms associated with the condition. Other related symptoms include – a rash on the scalp, neck or cheeks; thickened, cracked and discolored skin; scaly patches of skin at the site of the rash; red to brownish-gray patches; and lightened or darkened skin spots. As there is no specific cure for this inflammatory skin condition, identifying the symptoms at an early stage and incorporating a combination of treatment methods like medications, skin care, and lifestyle changes can help prevent flare-ups. ICD-10-CM codes used to indicate a diagnosis of AD include –

  • L20 – Atopic dermatitis
    • L20.0 – Besnier’s prurigo
    • L20.8 – Other atopic dermatitis
    • L20.81 – Atopic neurodermatitis
    • L20.82 – Flexural eczema
    • L20.83 – Infantile (acute) (chronic) eczema
    • L20.84 – Intrinsic (allergic) eczema
    • L20.89 – Other atopic dermatitis
  • L20.9 – Atopic dermatitis, unspecified

Anaphylaxis – Anaphylaxis is a specific allergic reaction to venom, food, or medication. In most cases, it is caused by eating foods that are known to cause allergies (such as peanuts or tree nuts). It causes the immune system to release a flood of chemicals that can make the patient go into shock – the patient’s blood pressure drops suddenly and the airways narrow, blocking breathing. This allergic condition causes a series of symptoms like – rash, low pulse, abdominal pain, facial swelling, trouble breathing, low pulse, wheezing, difficulty swallowing, and itchy skin. The symptoms often begin within minutes after a person eats a problem food. Relevant ICD-10 codes to document such anaphylactic reactions related to food include –

  • T78 Adverse effects, not elsewhere classified
  • T78.0 Anaphylactic reaction due to food
    • T78.00 Anaphylactic reaction due to unspecified food
    • T78.01 Anaphylactic reaction due to peanuts
    • T78.02 Anaphylactic reaction due to shellfish (crustaceans)
    • T78.03 Anaphylactic reaction due to other fish
    • T78.04 Anaphylactic reaction due to fruits and vegetables
    • T78.05 Anaphylactic reaction due to tree nuts and seeds
    • T78.06 Anaphylactic reaction due to food additives
    • T78.07 Anaphylactic reaction due to milk and dairy products
    • T78.08 Anaphylactic reaction due to eggs
    • T78.09 Anaphylactic reaction due to other food products
  • T78.1 Other adverse food reactions, not elsewhere classified
  • T78.2 Anaphylactic shock, unspecified

The outcome of the treatment depends largely on the severity of the allergic condition. Generally, seasonal allergies can be well managed with medications. However, severe allergies require long-term treatment. Managing the allergies before one’s body has a chance to respond to substances adversely is one of the top ways to prevent allergies. Other strategies to effectively manage and prevent allergies include – covering the mouth and nose while performing yard work, staying indoors when pollen counts are high, avoiding exercising outdoors early in the morning, and keeping the windows and doors shut as frequently as possible during the allergy seasons.

Medical billing and coding for different allergic conditions can be challenging, as there are numerous codes associated with these conditions. Allergy and sleep medicine medical billing services can be outsourced to a reliable provider in USA that offers the services of AAPC–certified coding specialists. Thereby, healthcare practices can ensure correct and timely medical billing and claims submission.