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V07.1 Desensitization to Allergens Denials

  1. Default V07.1 Desensitization to Allergens Denials
    Medical Coding Books
    We are experiencing in the past 2 weeks denials from outstate BCBS for claims with V07.1 and CPTs 95115/95117. We have always used this Dx code and CPT combination with no problems. Anyone else seeing this? Wondering if some how related to some encoding systems erroneously set to believe ICD-10 went into effect Oct 1, 2014?

    I understand ICD-10-CM still does not currently have a specific Dx code for Desensitization to allergens and it has been proposed to eventually add the code used internationally, Z51.6. Due to the freeze, this has not been done yet and currently Z51.89 is suggested by references I have consulted. Has anyone heard more on this issue?

    Cathy Gorka, CCS-P
    HIM & Coding Associate

  2. #2
    Columbia, MO
    Last edited by mitchellde; 10-17-2014 at 10:50 AM.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Columbia, MO
    Z51 codes are all aftercare codes, ICD -10 is different from ICD-10 CM which means they will have to add it to the ICD-10 CM code set before it can be used. The freeze is up this year for ICD-10 CM so possibly 2016.
    The big question I ask is what does the denial state as the reason for the denial.

    Debra A. Mitchell, MSPH, CPC-H

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