ICD-10 Coding for Milk Protein Allergy(Z91.011, K52.21)
Complete ICD-10-CM coding and documentation guide for Milk Protein Allergy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Milk Protein Allergy
Z91.0-Z91.01Primary Range
Personal history of allergy to milk products
This range includes codes for documenting allergies to milk products, which is central to milk protein allergy diagnosis.
Gastroenteritis and colitis due to food protein
This range includes codes for food protein-induced enterocolitis syndrome (FPIES), a condition related to milk protein allergy.
Lactose intolerance
This range is used to differentiate lactose intolerance from milk protein allergy.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Z91.011 | Allergy to milk products | Use for confirmed milk protein allergies, both IgE and non-IgE mediated. |
|
| K52.21 | Food protein-induced enterocolitis syndrome | Use when FPIES is diagnosed in conjunction with milk protein allergy. |
|
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 milk protein allergy
Essential facts and insights about Milk Protein Allergy
Primary ICD-10-CM Codes for milk protein allergy
Decision Criteria
clinical Criteria
- Presence of IgE antibodies or positive skin prick test
documentation Criteria
- Detailed elimination diet and challenge test results
Applicable To
- IgE-mediated milk allergy
- Non-IgE-mediated milk allergy
Excludes
- Lactose intolerance (E73.-)
Clinical Validation Requirements
- Positive IgE test to milk proteins
- Positive skin prick test
- Symptom resolution on elimination diet
Code-Specific Risks
- Confusing with lactose intolerance
- Incorrect sequencing with manifestation codes
Coding Notes
- Ensure documentation specifies IgE vs non-IgE allergy to avoid coding errors.
K52.21 - Food protein-induced enterocolitis syndrome
Use when FPIES is diagnosed in conjunction with milk protein allergy.
Applicable To
- FPIES due to milk protein
Clinical Validation Requirements
- Documented elimination diet response
- Positive oral food challenge
Coding Notes
Ensure FPIES is documented as related to milk protein.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Food protein-induced enterocolitis syndrome
K52.21Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Lactose intolerance, unspecified
E73.9Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Milk Protein Allergy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z91.011.
Impact
Clinical: Misdiagnosis and inappropriate treatment, Regulatory: Non-compliance with coding standards, Financial: Potential claim rejections
Mitigation Strategy
Ensure clear documentation of allergy type, Specify test results and clinical findings
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate patient records and statistics.
Mitigation Strategy
Use Z91.011 for allergies and E73.- for intolerances.
Impact
Using Z91.011 for non-allergic conditions
Mitigation Strategy
Regular training on allergy vs intolerance 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 Milk Protein Allergy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Milk Protein Allergy
Use these documentation templates to ensure complete and accurate documentation for Milk Protein Allergy. These templates include all required elements for proper coding and billing.
Pediatric Allergy Visit
Specialty: PediatricsRequired Elements
- History of present illness
- Elimination diet details
- Physical examination findings
- Test results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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