ICD-10 Coding for Allergic Reaction to Food(T78.1XXA, T78.09XA)
Complete ICD-10-CM coding and documentation guide for Allergic Reaction to Food. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Allergic Reaction to Food
T78.0-T78.1Primary Range
Adverse effects, not elsewhere classified
This range includes codes for adverse reactions to food, including anaphylaxis and other unspecified allergic reactions.
Personal history of allergy to food
These codes document known allergies to specific foods, which are used alongside primary codes for acute reactions.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| T78.1XXA | Adverse food reaction, initial encounter | Use when the specific allergen is not identified, but an adverse reaction is confirmed. |
|
| T78.09XA | Anaphylactic reaction due to other foods, initial encounter | Use for confirmed anaphylactic reactions to food. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for allergic reaction to food
Essential facts and insights about Allergic Reaction to Food
Primary ICD-10-CM Codes for allergic reaction to food
Decision Criteria
clinical Criteria
- Presence of adverse reaction symptoms without specific allergen identification
Applicable To
- Food allergy, unspecified
Excludes
- Anaphylactic reaction due to food (T78.0)
Clinical Validation Requirements
- Documented adverse reaction to food without specific allergen identification
Code-Specific Risks
- Risk of under-documenting specific allergens
Coding Notes
- Ensure documentation specifies the nature of the reaction and any known allergens.
T78.09XA - Anaphylactic reaction due to other foods, initial encounter
Use for confirmed anaphylactic reactions to food.
Applicable To
- Anaphylactic shock due to food
Excludes
- Adverse food reaction, unspecified (T78.1)
Clinical Validation Requirements
- Confirmed anaphylaxis with severe symptoms such as hypotension or respiratory distress
Coding Notes
Ensure documentation includes specific allergen and reaction details.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Allergic Reaction to Food to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code T78.1XXA.
Impact
Clinical: Ambiguity in patient records can lead to inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential loss of reimbursement for specific allergy management.
Mitigation Strategy
Always specify the type of nut (e.g., peanut, walnut)., Use structured fields in EHR for allergen documentation.
Impact
Reimbursement: May lead to underpayment if severity is not captured., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on the prevalence of specific food allergies.
Mitigation Strategy
Always document and code specific symptoms if treated independently.
Impact
Failure to document specific allergens can lead to audit discrepancies.
Mitigation Strategy
Use structured documentation templates to capture detailed allergen information.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Allergic Reaction to Food, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Allergic Reaction to Food
Use these documentation templates to ensure complete and accurate documentation for Allergic Reaction to Food. These templates include all required elements for proper coding and billing.
Emergency Department Visit for Anaphylaxis
Specialty: Emergency MedicineRequired Elements
- Allergen exposure
- Reaction timing
- Symptoms
- Treatment administered
- Diagnostic evidence
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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