ICD-10 Coding for Anaphylaxis(T78.2XXA, T80.52XA)
Complete ICD-10-CM coding and documentation guide for Anaphylaxis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Anaphylaxis
T78.0-T78.2Primary Range
Anaphylactic reactions
This range includes codes for anaphylactic reactions due to various causes, including food and unspecified triggers.
Anaphylactic reaction due to serum
This range is used for anaphylactic reactions specifically related to serum, such as vaccines.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| T78.2XXA | Anaphylactic shock, unspecified | Use when the trigger of anaphylaxis is unknown or unspecified. |
|
| T80.52XA | Anaphylactic reaction due to serum | Use for anaphylactic reactions following vaccine or serum administration. |
|
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 anaphylaxis
Essential facts and insights about Anaphylaxis
Primary ICD-10-CM Codes for anaphylaxis
Decision Criteria
clinical Criteria
- Acute onset with multi-system involvement
documentation Criteria
- Lack of specific trigger documentation
Applicable To
- Anaphylactic shock NOS
Excludes
- Anaphylactic reaction due to serum (T80.5)
Clinical Validation Requirements
- Involvement of at least two systems (e.g., skin and respiratory)
- Documentation of acute onset
Code-Specific Risks
- Risk of undercoding if specific trigger is known but not documented.
Coding Notes
- Ensure documentation specifies the systems involved and any known triggers.
T80.52XA - Anaphylactic reaction due to serum
Use for anaphylactic reactions following vaccine or serum administration.
Applicable To
- Anaphylactic reaction to vaccines
Excludes
- Anaphylactic shock, unspecified (T78.2XXA)
Clinical Validation Requirements
- Temporal relationship to vaccine administration
- Severe symptoms such as hypotension or laryngeal edema
Coding Notes
Ensure proper sequencing with vaccine codes.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Anaphylaxis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code T78.2XXA.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to insufficient detail.
Mitigation Strategy
Use specific terms for symptoms and triggers, Follow documentation templates
Impact
Reimbursement: May lead to incorrect DRG assignment and reimbursement., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Document and code the specific trigger first, such as T78.0XXA for food-induced anaphylaxis.
Impact
Use of unspecified codes without investigation of triggers.
Mitigation Strategy
Document all known triggers and symptoms to support specific coding.
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 Anaphylaxis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Anaphylaxis
Use these documentation templates to ensure complete and accurate documentation for Anaphylaxis. These templates include all required elements for proper coding and billing.
Emergency Department Anaphylaxis
Specialty: Emergency MedicineRequired Elements
- Exposure details
- Symptoms onset and systems involved
- Treatment administered and response
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Anaphylaxis? Ask your questions below.