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Food Allergy Dx Coding Clarification

  1. Default Food Allergy Dx Coding Clarification
    Medical Coding Books
    What is the correct Dx code for food allergy? When I look up allergy then food in the ICD-9 index it takes me to code 693.1. And when I look up food then allergy it takes me to 693.1 as well. When you look up code 693.1 in the tabular the category description is for "Dermatitis due to substances taken internally" then "Due to food". I've been told that the correct code for food allergy is 995.3 which is for "Allergy, unspecified". Can someone help clarify the correct code for food allergy.

    Sincerely,

    Tracy Powell

  2. Default
    What about 995.7 - Other adverse food reactions, not elsewhere classified? Since food allergy is really non specific, and doesn't state what kind of allergic reaction the patient had, or what kind of food it was from, I think this would be a more appropriate code. Under 995.7 it does state "use additional code to identify the type of reaction such as "hives" (708.0), or Wheezing (786.07). I could be wrong, so I'd wait for another opinion.

  3. Default
    I think 995.7 is also a good code to use, but I'm curious what E-code would be used with it? I know you don't NEED an e-code along with this one, but don't you think there would be one?

  4. #4
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    Speaking as a patient here for the moment. I have several food allergies and have had several ER visits in the past year that have all been coded using 995 codes (depending on which food allergy was responsible) with additional codes identifying the type of reaction - however I have always been anaphylactic at that time. The couple of times that I have a had regular office visits for my food allergies they have been coded using the 693.1 code.

    These examples actually involve 2 hospitals and 3 different physician offices (I have had multiple insurances over the past 2 years). I do wish I9 was a little more specific in regards to food allergies.

  5. #5
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    You would not use 693.1 as a code for a patient that has food allergies,. That code is for patient that presents with an acute condition of dermatitis that is due having ingested a substance that they are allergic to. If the patient is coming to the office for their food allergy status the the only good code in ICD-9 CM for this is V65.3 which if you look includes food allergies. You should never use a code that does not describe the patient condition at that encounter.
    ICD-10 CM does fix this with Z codes for specific allergy status.

    Debra A. Mitchell, MSPH, CPC-H

  6. #6
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    That is good to know - I hadn't found that code so thanks.

    It is nice to hear that I10 will help with some of this confusion with food allergies. I haven't had a chance to look at I10 in detail yet (just got a job in the field and before that I was focused on looking for a job and let my prep for I10 slide). Hopefully, I will be able to spend some quality time with I10 come August when I am going to participate in a local training course for I10.

  7. #7
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    I just began coding for an Allergy specialist. The previous coder would code DX code 995.61 for Anaphylactic reaction to Peanut (this is an example) even when the patient was not CURRENTLY experiencing anaphylaxis, they were just in to see the doctor for a routine follow up for their peanut allergy. I was under the impression that if the patient is not currently experiencing anaphylaxis that code 995.61 should not be used. I am also wondering if "history of" codes for food allergy would be appropriate to use. For example code v15.01
    Last edited by chriskhans; 05-27-2014 at 12:36 PM.

  8. #8
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    No you should not use a code for anaphylactic reaction when the patient is there for routine allergy injections. You need a V code only for prophylactic injection. The V15 code is not allowed first listed for a routine visit then use a different V code for follow up with the V15 code secondary

    Debra A. Mitchell, MSPH, CPC-H

  9. #9
    Default In regards to ICD-10
    Are you saying when a patient is receiving bee immunotherapy we should use the status code? The AAAAI is saying we should use the injury code because the patient is receiving "active treatment".

  10. #10
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    The injury codes are for active injury status. If the patient is receiving routine injections due to having the status of the allergy then this is not active treatment it is prophylactic treatment for the purpose of desensitization.

    Debra A. Mitchell, MSPH, CPC-H

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