Coding Information

Bill Type Codes: Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the policy does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the policy should be assumed to apply equally to all claims. 999 Not Applicable Revenue Codes: Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory; unless specified in the policy services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the policy should be assumed to apply equally to all Revenue Codes. 99999 Not Applicable CPT/HCPCS Codes: Group 1 Paragraph:   Note: Providers are reminded to refer to the long descriptors of the CPT codes in their CPT book. Group 1 CPT Codes: 0165U PEANUT ALLERGEN-SPECIFIC QUANTITATIVE ASSESSMENT OF MULTIPLE EPITOPES USING ENZYME-LINKED IMMUNOSORBENT ASSAY (ELISA), BLOOD, INDIVIDUAL EPITOPE RESULTS AND PROBABILITY OF PEANUT ALLERGY 0178U PEANUT ALLERGEN-SPECIFIC QUANTITATIVE ASSESSMENT OF MULTIPLE EPITOPES USING ENZYME-LINKED IMMUNOSORBENT ASSAY (ELISA), BLOOD, REPORT OF MINIMUM ELICITING EXPOSURE FOR A CLINICAL REACTION 86003 ALLERGEN SPECIFIC IGE; QUANTITATIVE OR SEMIQUANTITATIVE, CRUDE ALLERGEN EXTRACT, EACH 86008 ALLERGEN SPECIFIC IGE; QUANTITATIVE OR SEMIQUANTITATIVE, RECOMBINANT OR PURIFIED COMPONENT, EACH 95004 PERCUTANEOUS TESTS (SCRATCH, PUNCTURE, PRICK) WITH ALLERGENIC EXTRACTS, IMMEDIATE TYPE REACTION, INCLUDING TEST INTERPRETATION AND REPORT, SPECIFY NUMBER OF TESTS 95017 ALLERGY TESTING, ANY COMBINATION OF PERCUTANEOUS (SCRATCH, PUNCTURE, PRICK) AND INTRACUTANEOUS (INTRADERMAL), SEQUENTIAL AND INCREMENTAL, WITH VENOMS, IMMEDIATE TYPE REACTION, INCLUDING TEST INTERPRETATION AND REPORT, SPECIFY NUMBER OF TESTS 95018 ALLERGY TESTING, ANY COMBINATION OF PERCUTANEOUS (SCRATCH, PUNCTURE, PRICK) AND INTRACUTANEOUS (INTRADERMAL), SEQUENTIAL AND INCREMENTAL, WITH DRUGS OR BIOLOGICALS, IMMEDIATE TYPE REACTION, INCLUDING TEST INTERPRETATION AND REPORT, SPECIFY NUMBER OF TESTS 95024 INTRACUTANEOUS (INTRADERMAL) TESTS WITH ALLERGENIC EXTRACTS, IMMEDIATE TYPE REACTION, INCLUDING TEST INTERPRETATION AND REPORT, SPECIFY NUMBER OF TESTS 95027 INTRACUTANEOUS (INTRADERMAL) TESTS, SEQUENTIAL AND INCREMENTAL, WITH ALLERGENIC EXTRACTS FOR AIRBORNE ALLERGENS, IMMEDIATE TYPE REACTION, INCLUDING TEST INTERPRETATION AND REPORT, SPECIFY NUMBER OF TESTS 95028 INTRACUTANEOUS (INTRADERMAL) TESTS WITH ALLERGENIC EXTRACTS, DELAYED TYPE REACTION, INCLUDING READING, SPECIFY NUMBER OF TESTS Group 2 Paragraph: N/A Group 2 CPT Codes: 82785 GAMMAGLOBULIN (IMMUNOGLOBULIN); IGE 86003 ALLERGEN SPECIFIC IGE; QUANTITATIVE OR SEMIQUANTITATIVE, CRUDE ALLERGEN EXTRACT, EACH 86008 ALLERGEN SPECIFIC IGE; QUANTITATIVE OR SEMIQUANTITATIVE, RECOMBINANT OR PURIFIED COMPONENT, EACH 95070 INHALATION BRONCHIAL CHALLENGE TESTING (NOT INCLUDING NECESSARY PULMONARY FUNCTION TESTS), WITH HISTAMINE, METHACHOLINE, OR SIMILAR COMPOUNDS Group 3 Paragraph: N/A Group 3 CPT Codes: 95044 PATCH OR APPLICATION TEST(S) (SPECIFY NUMBER OF TESTS) 95052 PHOTO PATCH TEST(S) (SPECIFY NUMBER OF TESTS) 95056 PHOTO TESTS 95060 OPHTHALMIC MUCOUS MEMBRANE TESTS 95065 DIRECT NASAL MUCOUS MEMBRANE TEST Group 4 Paragraph: N/A Group 4 CPT Codes: 95076 INGESTION CHALLENGE TEST (SEQUENTIAL AND INCREMENTAL INGESTION OF TEST ITEMS, EG, FOOD, DRUG OR OTHER SUBSTANCE); INITIAL 120 MINUTES OF TESTING 95079 INGESTION CHALLENGE TEST (SEQUENTIAL AND INCREMENTAL INGESTION OF TEST ITEMS, EG, FOOD, DRUG OR OTHER SUBSTANCE); EACH ADDITIONAL 60 MINUTES OF TESTING (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) Group 5 Paragraph: The following CPT codes are non-covered: Group 5 CPT Codes: 86001 ALLERGEN SPECIFIC IGG QUANTITATIVE OR SEMIQUANTITATIVE, EACH ALLERGEN 86005 ALLERGEN SPECIFIC IGE; QUALITATIVE, MULTIALLERGEN SCREEN (EG, DISK, SPONGE, CARD) ICD-10 Codes That Are Covered It is the provider’s responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim(s) submitted. The following ICD-10-CM codes support medical necessity and provide coverage for CPT codes: 86003, 86008, 95004, 95017, 95018, 95024, 95027, 95028, 0165U, and 0178U. H10.411 Chronic giant papillary conjunctivitis, right eye H10.412 Chronic giant papillary conjunctivitis, left eye H10.413 Chronic giant papillary conjunctivitis, bilateral H10.44 Vernal conjunctivitis H10.45 Other chronic allergic conjunctivitis H65.411 Chronic allergic otitis media, right ear H65.412 Chronic allergic otitis media, left ear H65.413 Chronic allergic otitis media, bilateral J30.1 Allergic rhinitis due to pollen J30.2 Other seasonal allergic rhinitis J30.5 Allergic rhinitis due to food J30.81 Allergic rhinitis due to animal (cat) (dog) hair and dander J30.89 Other allergic rhinitis J30.9 Allergic rhinitis, unspecified J31.0 Chronic rhinitis J32.0 Chronic maxillary sinusitis J32.1 Chronic frontal sinusitis J32.2 Chronic ethmoidal sinusitis J32.3 Chronic sphenoidal sinusitis J45.20 Mild intermittent asthma, uncomplicated J45.21 Mild intermittent asthma with (acute) exacerbation J45.22 Mild intermittent asthma with status asthmaticus J45.30 Mild persistent asthma, uncomplicated J45.31 Mild persistent asthma with (acute) exacerbation J45.32 Mild persistent asthma with status asthmaticus J45.40 Moderate persistent asthma, uncomplicated J45.41 Moderate persistent asthma with (acute) exacerbation J45.42 Moderate persistent asthma with status asthmaticus J45.50 Severe persistent asthma, uncomplicated J45.51 Severe persistent asthma with (acute) exacerbation J45.52 Severe persistent asthma with status asthmaticus J45.901 Unspecified asthma with (acute) exacerbation J45.902 Unspecified asthma with status asthmaticus J45.909 Unspecified asthma, uncomplicated J45.991 Cough variant asthma J45.998 Other asthma L20.0 Besnier's prurigo L20.81 Atopic neurodermatitis L20.82 Flexural eczema L20.84 Intrinsic (allergic) eczema L20.89 Other atopic dermatitis L27.2 Dermatitis due to ingested food L50.0 Allergic urticaria L50.1 Idiopathic urticaria L50.6 Contact urticaria L50.8 Other urticaria R05.3 Chronic cough T36.0X5A Adverse effect of penicillins, initial encounter T36.0X5D Adverse effect of penicillins, subsequent encounter T36.0X5S Adverse effect of penicillins, sequela T36.1X5A Adverse effect of cephalosporins and other beta-lactam antibiotics, initial encounter T36.1X5D Adverse effect of cephalosporins and other beta-lactam antibiotics, subsequent encounter T36.1X5S Adverse effect of cephalosporins and other beta-lactam antibiotics, sequela T36.4X5A Adverse effect of tetracyclines, initial encounter T36.4X5D Adverse effect of tetracyclines, subsequent encounter T36.4X5S Adverse effect of tetracyclines, sequela T36.8X5A Adverse effect of other systemic antibiotics, initial encounter T36.8X5D Adverse effect of other systemic antibiotics, subsequent encounter T36.8X5S Adverse effect of other systemic antibiotics, sequela T37.0X5A Adverse effect of sulfonamides, initial encounter T37.0X5D Adverse effect of sulfonamides, subsequent encounter T37.0X5S Adverse effect of sulfonamides, sequela T37.8X5A Adverse effect of other specified systemic anti-infectives and antiparasitics, initial encounter T37.8X5D Adverse effect of other specified systemic anti-infectives and antiparasitics, subsequent encounter T37.8X5S Adverse effect of other specified systemic anti-infectives and antiparasitics, sequela T39.015A Adverse effect of aspirin, initial encounter T39.015D Adverse effect of aspirin, subsequent encounter T39.015S Adverse effect of aspirin, sequela T39.1X5A Adverse effect of 4-Aminophenol derivatives, initial encounter T39.1X5D Adverse effect of 4-Aminophenol derivatives, subsequent encounter T39.1X5S Adverse effect of 4-Aminophenol derivatives, sequela T45.0X5A Adverse effect of antiallergic and antiemetic drugs, initial encounter T45.0X5D Adverse effect of antiallergic and antiemetic drugs, subsequent encounter T45.0X5S Adverse effect of antiallergic and antiemetic drugs, sequela T50.995A Adverse effect of other drugs, medicaments and biological substances, initial encounter T50.995D Adverse effect of other drugs, medicaments and biological substances, subsequent encounter T50.995S Adverse effect of other drugs, medicaments and biological substances, sequela T63.421A Toxic effect of venom of ants, accidental (unintentional), initial encounter T63.421D Toxic effect of venom of ants, accidental (unintentional), subsequent encounter T63.421S Toxic effect of venom of ants, accidental (unintentional), sequela T63.422A Toxic effect of venom of ants, intentional self-harm, initial encounter T63.422D Toxic effect of venom of ants, intentional self-harm, subsequent encounter T63.422S Toxic effect of venom of ants, intentional self-harm, sequela T63.423A Toxic effect of venom of ants, assault, initial encounter T63.423D Toxic effect of venom of ants, assault, subsequent encounter T63.423S Toxic effect of venom of ants, assault, sequela T63.424A Toxic effect of venom of ants, undetermined, initial encounter T63.424D Toxic effect of venom of ants, undetermined, subsequent encounter T63.424S Toxic effect of venom of ants, undetermined, sequela T63.431A Toxic effect of venom of caterpillars, accidental (unintentional), initial encounter T63.431D Toxic effect of venom of caterpillars, accidental (unintentional), subsequent encounter T63.431S Toxic effect of venom of caterpillars, accidental (unintentional), sequela T63.432A Toxic effect of venom of caterpillars, intentional self-harm, initial encounter T63.432D Toxic effect of venom of caterpillars, intentional self-harm, subsequent encounter T63.432S Toxic effect of venom of caterpillars, intentional self-harm, sequela T63.433A Toxic effect of venom of caterpillars, assault, initial encounter T63.433D Toxic effect of venom of caterpillars, assault, subsequent encounter T63.433S Toxic effect of venom of caterpillars, assault, sequela T63.434A Toxic effect of venom of caterpillars, undetermined, initial encounter T63.434D Toxic effect of venom of caterpillars, undetermined, subsequent encounter T63.434S Toxic effect of venom of caterpillars, undetermined, sequela T63.441A Toxic effect of venom of bees, accidental (unintentional), initial encounter T63.441D Toxic effect of venom of bees, accidental (unintentional), subsequent encounter T63.441S Toxic effect of venom of bees, accidental (unintentional), sequela T63.442A Toxic effect of venom of bees, intentional self-harm, initial encounter T63.442D Toxic effect of venom of bees, intentional self-harm, subsequent encounter T63.442S Toxic effect of venom of bees, intentional self-harm, sequela T63.443A Toxic effect of venom of bees, assault, initial encounter T63.443D Toxic effect of venom of bees, assault, subsequent encounter T63.443S Toxic effect of venom of bees, assault, sequela T63.444A Toxic effect of venom of bees, undetermined, initial encounter T63.444D Toxic effect of venom of bees, undetermined, subsequent encounter T63.444S Toxic effect of venom of bees, undetermined, sequela T63.451A Toxic effect of venom of hornets, accidental (unintentional), initial encounter T63.451D Toxic effect of venom of hornets, accidental (unintentional), subsequent encounter T63.451S Toxic effect of venom of hornets, accidental (unintentional), sequela T63.452A Toxic effect of venom of hornets, intentional self-harm, initial encounter T63.452D Toxic effect of venom of hornets, intentional self-harm, subsequent encounter T63.452S Toxic effect of venom of hornets, intentional self-harm, sequela T63.453A Toxic effect of venom of hornets, assault, initial encounter T63.453D Toxic effect of venom of hornets, assault, subsequent encounter T63.453S Toxic effect of venom of hornets, assault, sequela T63.454A Toxic effect of venom of hornets, undetermined, initial encounter T63.454D Toxic effect of venom of hornets, undetermined, subsequent encounter T63.454S Toxic effect of venom of hornets, undetermined, sequela T63.461A Toxic effect of venom of wasps, accidental (unintentional), initial encounter T63.461D Toxic effect of venom of wasps, accidental (unintentional), subsequent encounter T63.461S Toxic effect of venom of wasps, accidental (unintentional), sequela T63.462A Toxic effect of venom of wasps, intentional self-harm, initial encounter T63.462D Toxic effect of venom of wasps, intentional self-harm, subsequent encounter T63.462S Toxic effect of venom of wasps, intentional self-harm, sequela T63.463A Toxic effect of venom of wasps, assault, initial encounter T63.463D Toxic effect of venom of wasps, assault, subsequent encounter T63.463S Toxic effect of venom of wasps, assault, sequela T63.464A Toxic effect of venom of wasps, undetermined, initial encounter T63.464D Toxic effect of venom of wasps, undetermined, subsequent encounter T63.464S Toxic effect of venom of wasps, undetermined, sequela T63.481A Toxic effect of venom of other arthropod, accidental (unintentional), initial encounter T63.481D Toxic effect of venom of other arthropod, accidental (unintentional), subsequent encounter T63.481S Toxic effect of venom of other arthropod, accidental (unintentional), sequela T63.482A Toxic effect of venom of other arthropod, intentional self-harm, initial encounter T63.482D Toxic effect of venom of other arthropod, intentional self-harm, subsequent encounter T63.482S Toxic effect of venom of other arthropod, intentional self-harm, sequela T63.483A Toxic effect of venom of other arthropod, assault, initial encounter T63.483D Toxic effect of venom of other arthropod, assault, subsequent encounter T63.483S Toxic effect of venom of other arthropod, assault, sequela T63.484A Toxic effect of venom of other arthropod, undetermined, initial encounter T63.484D Toxic effect of venom of other arthropod, undetermined, subsequent encounter T63.484S Toxic effect of venom of other arthropod, undetermined, sequela T78.01XA Anaphylactic reaction due to peanuts, initial encounter T78.01XD Anaphylactic reaction due to peanuts, subsequent encounter T78.01XS Anaphylactic reaction due to peanuts, sequela T78.02XA Anaphylactic reaction due to shellfish (crustaceans), initial encounter T78.02XD Anaphylactic reaction due to shellfish (crustaceans), subsequent encounter T78.02XS Anaphylactic reaction due to shellfish (crustaceans), sequela T78.03XA Anaphylactic reaction due to other fish, initial encounter T78.03XD Anaphylactic reaction due to other fish, subsequent encounter T78.03XS Anaphylactic reaction due to other fish, sequela T78.04XA Anaphylactic reaction due to fruits and vegetables, initial encounter T78.04XD Anaphylactic reaction due to fruits and vegetables, subsequent encounter T78.04XS Anaphylactic reaction due to fruits and vegetables, sequela T78.05XA Anaphylactic reaction due to tree nuts and seeds, initial encounter T78.05XD Anaphylactic reaction due to tree nuts and seeds, subsequent encounter T78.05XS Anaphylactic reaction due to tree nuts and seeds, sequela T78.06XA Anaphylactic reaction due to food additives, initial encounter T78.06XD Anaphylactic reaction due to food additives, subsequent encounter T78.06XS Anaphylactic reaction due to food additives, sequela T78.07XA Anaphylactic reaction due to milk and dairy products, initial encounter T78.07XD Anaphylactic reaction due to milk and dairy products, subsequent encounter T78.07XS Anaphylactic reaction due to milk and dairy products, sequela T78.08XA Anaphylactic reaction due to eggs, initial encounter T78.08XD Anaphylactic reaction due to eggs, subsequent encounter T78.08XS Anaphylactic reaction due to eggs, sequela T78.09XA Anaphylactic reaction due to other food products, initial encounter T78.09XD Anaphylactic reaction due to other food products, subsequent encounter T78.09XS Anaphylactic reaction due to other food products, sequela T78.3XXA Angioneurotic edema, initial encounter T78.3XXD Angioneurotic edema, subsequent encounter T78.3XXS Angioneurotic edema, sequela T78.40XA Allergy, unspecified, initial encounter T78.40XD Allergy, unspecified, subsequent encounter T78.40XS Allergy, unspecified, sequela T78.49XA Other allergy, initial encounter T78.49XD Other allergy, subsequent encounter T78.49XS Other allergy, sequela T80.51XA Anaphylactic reaction due to administration of blood and blood products, initial encounter T80.51XD Anaphylactic reaction due to administration of blood and blood products, subsequent encounter T80.51XS Anaphylactic reaction due to administration of blood and blood products, sequela T80.52XA Anaphylactic reaction due to vaccination, initial encounter T80.52XD Anaphylactic reaction due to vaccination, subsequent encounter T80.52XS Anaphylactic reaction due to vaccination, sequela T80.59XA Anaphylactic reaction due to other serum, initial encounter T80.59XD Anaphylactic reaction due to other serum, subsequent encounter T80.59XS Anaphylactic reaction due to other serum, sequela T80.61XA Other serum reaction due to administration of blood and blood products, initial encounter T80.61XD Other serum reaction due to administration of blood and blood products, subsequent encounter T80.61XS Other serum reaction due to administration of blood and blood products, sequela T80.62XA Other serum reaction due to vaccination, initial encounter T80.62XD Other serum reaction due to vaccination, subsequent encounter T80.62XS Other serum reaction due to vaccination, sequela T80.69XA Other serum reaction due to other serum, initial encounter T80.69XD Other serum reaction due to other serum, subsequent encounter T80.69XS Other serum reaction due to other serum, sequela Z91.010 Allergy to peanuts Z91.011 Allergy to milk products Z91.012 Allergy to eggs Z91.013 Allergy to seafood Z91.014 Allergy to mammalian meats Z91.018 Allergy to other foods It is the provider’s responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim(s) submitted. The following ICD-10-CM codes support medical necessity and provide coverage for CPT codes: 82785, 86003 (Specific IgE in-vitro Testing), 86008 and 95070. B44.0 Invasive pulmonary aspergillosis J30.1 Allergic rhinitis due to pollen J30.2 Other seasonal allergic rhinitis J30.5 Allergic rhinitis due to food J30.81 Allergic rhinitis due to animal (cat) (dog) hair and dander J30.89 Other allergic rhinitis J30.9 Allergic rhinitis, unspecified J31.0 Chronic rhinitis J32.3 Chronic sphenoidal sinusitis J45.20 Mild intermittent asthma, uncomplicated J45.21 Mild intermittent asthma with (acute) exacerbation J45.22 Mild intermittent asthma with status asthmaticus J45.30 Mild persistent asthma, uncomplicated J45.31 Mild persistent asthma with (acute) exacerbation J45.32 Mild persistent asthma with status asthmaticus J45.40 Moderate persistent asthma, uncomplicated J45.41 Moderate persistent asthma with (acute) exacerbation J45.42 Moderate persistent asthma with status asthmaticus J45.50 Severe persistent asthma, uncomplicated J45.51 Severe persistent asthma with (acute) exacerbation J45.52 Severe persistent asthma with status asthmaticus J45.901 Unspecified asthma with (acute) exacerbation J45.902 Unspecified asthma with status asthmaticus J45.909 Unspecified asthma, uncomplicated J45.991 Cough variant asthma J45.998 Other asthma L20.82 Flexural eczema L20.84 Intrinsic (allergic) eczema L20.89 Other atopic dermatitis L50.0 Allergic urticaria L50.1 Idiopathic urticaria L50.3 Dermatographic urticaria L50.6 Contact urticaria L50.8 Other urticaria R05.3 Chronic cough T63.91XA Toxic effect of contact with unspecified venomous animal, accidental (unintentional), initial encounter T63.91XD Toxic effect of contact with unspecified venomous animal, accidental (unintentional), subsequent encounter T63.91XS Toxic effect of contact with unspecified venomous animal, accidental (unintentional), sequela T63.92XA Toxic effect of contact with unspecified venomous animal, intentional self-harm, initial encounter T63.92XD Toxic effect of contact with unspecified venomous animal, intentional self-harm, subsequent encounter T63.92XS Toxic effect of contact with unspecified venomous animal, intentional self-harm, sequela T63.93XA Toxic effect of contact with unspecified venomous animal, assault, initial encounter T63.93XD Toxic effect of contact with unspecified venomous animal, assault, subsequent encounter T63.93XS Toxic effect of contact with unspecified venomous animal, assault, sequela T63.94XA Toxic effect of contact with unspecified venomous animal, undetermined, initial encounter T63.94XD Toxic effect of contact with unspecified venomous animal, undetermined, subsequent encounter T63.94XS Toxic effect of contact with unspecified venomous animal, undetermined, sequela T65.811A Toxic effect of latex, accidental (unintentional), initial encounter T65.811D Toxic effect of latex, accidental (unintentional), subsequent encounter T65.811S Toxic effect of latex, accidental (unintentional), sequela T65.812A Toxic effect of latex, intentional self-harm, initial encounter T65.812D Toxic effect of latex, intentional self-harm, subsequent encounter T65.812S Toxic effect of latex, intentional self-harm, sequela T65.813A Toxic effect of latex, assault, initial encounter T65.813D Toxic effect of latex, assault, subsequent encounter T65.813S Toxic effect of latex, assault, sequela T65.814A Toxic effect of latex, undetermined, initial encounter T65.814D Toxic effect of latex, undetermined, subsequent encounter T65.814S Toxic effect of latex, undetermined, sequela T78.01XA Anaphylactic reaction due to peanuts, initial encounter T78.01XD Anaphylactic reaction due to peanuts, subsequent encounter T78.01XS Anaphylactic reaction due to peanuts, sequela T78.02XA Anaphylactic reaction due to shellfish (crustaceans), initial encounter T78.02XD Anaphylactic reaction due to shellfish (crustaceans), subsequent encounter T78.02XS Anaphylactic reaction due to shellfish (crustaceans), sequela T78.03XA Anaphylactic reaction due to other fish, initial encounter T78.03XD Anaphylactic reaction due to other fish, subsequent encounter T78.03XS Anaphylactic reaction due to other fish, sequela T78.04XA Anaphylactic reaction due to fruits and vegetables, initial encounter T78.04XD Anaphylactic reaction due to fruits and vegetables, subsequent encounter T78.04XS Anaphylactic reaction due to fruits and vegetables, sequela T78.05XA Anaphylactic reaction due to tree nuts and seeds, initial encounter T78.05XD Anaphylactic reaction due to tree nuts and seeds, subsequent encounter T78.05XS Anaphylactic reaction due to tree nuts and seeds, sequela T78.06XA Anaphylactic reaction due to food additives, initial encounter T78.06XD Anaphylactic reaction due to food additives, subsequent encounter T78.06XS Anaphylactic reaction due to food additives, sequela T78.07XA Anaphylactic reaction due to milk and dairy products, initial encounter T78.07XD Anaphylactic reaction due to milk and dairy products, subsequent encounter T78.07XS Anaphylactic reaction due to milk and dairy products, sequela T78.08XA Anaphylactic reaction due to eggs, initial encounter T78.08XD Anaphylactic reaction due to eggs, subsequent encounter T78.08XS Anaphylactic reaction due to eggs, sequela T78.09XA Anaphylactic reaction due to other food products, initial encounter T78.09XD Anaphylactic reaction due to other food products, subsequent encounter T78.09XS Anaphylactic reaction due to other food products, sequela T78.40XA Allergy, unspecified, initial encounter T78.40XD Allergy, unspecified, subsequent encounter T78.40XS Allergy, unspecified, sequela Z86.19 Personal history of other infectious and parasitic diseases Z91.010 Allergy to peanuts Z91.011 Allergy to milk products Z91.012 Allergy to eggs Z91.013 Allergy to seafood Z91.014 Allergy to mammalian meats Z91.018 Allergy to other foods It is the provider’s responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim(s) submitted. The following ICD-10-CM codes support medical necessity and provide coverage for CPT codes: 95044, 95052, 95056, 95060, and 95065. L23.0 Allergic contact dermatitis due to metals L23.1 Allergic contact dermatitis due to adhesives L23.2 Allergic contact dermatitis due to cosmetics L23.3 Allergic contact dermatitis due to drugs in contact with skin L23.4 Allergic contact dermatitis due to dyes L23.5 Allergic contact dermatitis due to other chemical products L23.6 Allergic contact dermatitis due to food in contact with the skin L23.7 Allergic contact dermatitis due to plants, except food L23.81 Allergic contact dermatitis due to animal (cat) (dog) dander L23.89 Allergic contact dermatitis due to other agents L23.9 Allergic contact dermatitis, unspecified cause L24.0 Irritant contact dermatitis due to detergents L24.1 Irritant contact dermatitis due to oils and greases L24.2 Irritant contact dermatitis due to solvents L24.3 Irritant contact dermatitis due to cosmetics L24.4 Irritant contact dermatitis due to drugs in contact with skin L24.5 Irritant contact dermatitis due to other chemical products L24.6 Irritant contact dermatitis due to food in contact with skin L24.7 Irritant contact dermatitis due to plants, except food L24.81 Irritant contact dermatitis due to metals L24.89 Irritant contact dermatitis due to other agents L24.9 Irritant contact dermatitis, unspecified cause L25.0 Unspecified contact dermatitis due to cosmetics L25.1 Unspecified contact dermatitis due to drugs in contact with skin L25.2 Unspecified contact dermatitis due to dyes L25.3 Unspecified contact dermatitis due to other chemical products L25.4 Unspecified contact dermatitis due to food in contact with skin L25.5 Unspecified contact dermatitis due to plants, except food L25.8 Unspecified contact dermatitis due to other agents L25.9 Unspecified contact dermatitis, unspecified cause L30.8 Other specified dermatitis It is the provider’s responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim(s) submitted. The following ICD-10-CM codes support medical necessity and provide coverage for CPT codes: 95076 and 95079 (Ingestion Challenge Testing). L27.2 Dermatitis due to ingested food T36.0X5A Adverse effect of penicillins, initial encounter T36.0X5D Adverse effect of penicillins, subsequent encounter T36.0X5S Adverse effect of penicillins, sequela T36.1X5A Adverse effect of cephalosporins and other beta-lactam antibiotics, initial encounter T36.1X5D Adverse effect of cephalosporins and other beta-lactam antibiotics, subsequent encounter T36.1X5S Adverse effect of cephalosporins and other beta-lactam antibiotics, sequela T36.2X5A Adverse effect of chloramphenicol group, initial encounter T36.2X5D Adverse effect of chloramphenicol group, subsequent encounter T36.2X5S Adverse effect of chloramphenicol group, sequela T36.3X5A Adverse effect of macrolides, initial encounter T36.3X5D Adverse effect of macrolides, subsequent encounter T36.3X5S Adverse effect of macrolides, sequela T36.4X5A Adverse effect of tetracyclines, initial encounter T36.4X5D Adverse effect of tetracyclines, subsequent encounter T36.4X5S Adverse effect of tetracyclines, sequela T36.5X5A Adverse effect of aminoglycosides, initial encounter T36.5X5D Adverse effect of aminoglycosides, subsequent encounter T36.5X5S Adverse effect of aminoglycosides, sequela T36.6X5A Adverse effect of rifampicins, initial encounter T36.6X5D Adverse effect of rifampicins, subsequent encounter T36.6X5S Adverse effect of rifampicins, sequela T36.7X5A Adverse effect of antifungal antibiotics, systemically used, initial encounter T36.7X5D Adverse effect of antifungal antibiotics, systemically used, subsequent encounter T36.7X5S Adverse effect of antifungal antibiotics, systemically used, sequela T36.8X5A Adverse effect of other systemic antibiotics, initial encounter T36.8X5D Adverse effect of other systemic antibiotics, subsequent encounter T36.8X5S Adverse effect of other systemic antibiotics, sequela T37.0X5A Adverse effect of sulfonamides, initial encounter T37.0X5D Adverse effect of sulfonamides, subsequent encounter T37.0X5S Adverse effect of sulfonamides, sequela T37.1X5A Adverse effect of antimycobacterial drugs, initial encounter T37.1X5D Adverse effect of antimycobacterial drugs, subsequent encounter T37.1X5S Adverse effect of antimycobacterial drugs, sequela T37.2X5A Adverse effect of antimalarials and drugs acting on other blood protozoa, initial encounter T37.2X5D Adverse effect of antimalarials and drugs acting on other blood protozoa, subsequent encounter T37.2X5S Adverse effect of antimalarials and drugs acting on other blood protozoa, sequela T37.3X5A Adverse effect of other antiprotozoal drugs, initial encounter T37.3X5D Adverse effect of other antiprotozoal drugs, subsequent encounter T37.3X5S Adverse effect of other antiprotozoal drugs, sequela T37.4X5A Adverse effect of anthelminthics, initial encounter T37.4X5D Adverse effect of anthelminthics, subsequent encounter T37.4X5S Adverse effect of anthelminthics, sequela T37.5X5A Adverse effect of antiviral drugs, initial encounter T37.5X5D Adverse effect of antiviral drugs, subsequent encounter T37.5X5S Adverse effect of antiviral drugs, sequela T37.8X5A Adverse effect of other specified systemic anti-infectives and antiparasitics, initial encounter T37.8X5D Adverse effect of other specified systemic anti-infectives and antiparasitics, subsequent encounter T37.8X5S Adverse effect of other specified systemic anti-infectives and antiparasitics, sequela T38.0X5A Adverse effect of glucocorticoids and synthetic analogues, initial encounter T38.0X5D Adverse effect of glucocorticoids and synthetic analogues, subsequent encounter T38.0X5S Adverse effect of glucocorticoids and synthetic analogues, sequela T38.1X5A Adverse effect of thyroid hormones and substitutes, initial encounter T38.1X5D Adverse effect of thyroid hormones and substitutes, subsequent encounter T38.1X5S Adverse effect of thyroid hormones and substitutes, sequela T38.2X5A Adverse effect of antithyroid drugs, initial encounter T38.2X5D Adverse effect of antithyroid drugs, subsequent encounter T38.2X5S Adverse effect of antithyroid drugs, sequela T38.3X5A Adverse effect of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter T38.3X5D Adverse effect of insulin and oral hypoglycemic [antidiabetic] drugs, subsequent encounter T38.3X5S Adverse effect of insulin and oral hypoglycemic [antidiabetic] drugs, sequela T38.4X5A Adverse effect of oral contraceptives, initial encounter T38.4X5D Adverse effect of oral contraceptives, subsequent encounter T38.4X5S Adverse effect of oral contraceptives, sequela T38.5X5A Adverse effect of other estrogens and progestogens, initial encounter T38.5X5D Adverse effect of other estrogens and progestogens, subsequent encounter T38.5X5S Adverse effect of other estrogens and progestogens, sequela T38.6X5A Adverse effect of antigonadotrophins, antiestrogens, antiandrogens, not elsewhere classified, initial encounter T38.6X5D Adverse effect of antigonadotrophins, antiestrogens, antiandrogens, not elsewhere classified, subsequent encounter T38.6X5S Adverse effect of antigonadotrophins, antiestrogens, antiandrogens, not elsewhere classified, sequela T38.7X5A Adverse effect of androgens and anabolic congeners, initial encounter T38.7X5D Adverse effect of androgens and anabolic congeners, subsequent encounter T38.7X5S Adverse effect of androgens and anabolic congeners, sequela T38.815A Adverse effect of anterior pituitary [adenohypophyseal] hormones, initial encounter T38.815D Adverse effect of anterior pituitary [adenohypophyseal] hormones, subsequent encounter T38.815S Adverse effect of anterior pituitary [adenohypophyseal] hormones, sequela T38.895A Adverse effect of other hormones and synthetic substitutes, initial encounter T38.895D Adverse effect of other hormones and synthetic substitutes, subsequent encounter T38.895S Adverse effect of other hormones and synthetic substitutes, sequela T38.995A Adverse effect of other hormone antagonists, initial encounter T38.995D Adverse effect of other hormone antagonists, subsequent encounter T38.995S Adverse effect of other hormone antagonists, sequela T39.015A Adverse effect of aspirin, initial encounter T39.015D Adverse effect of aspirin, subsequent encounter T39.015S Adverse effect of aspirin, sequela T39.095A Adverse effect of salicylates, initial encounter T39.095D Adverse effect of salicylates, subsequent encounter T39.095S Adverse effect of salicylates, sequela T39.1X5A Adverse effect of 4-Aminophenol derivatives, initial encounter T39.1X5D Adverse effect of 4-Aminophenol derivatives, subsequent encounter T39.1X5S Adverse effect of 4-Aminophenol derivatives, sequela T39.2X5A Adverse effect of pyrazolone derivatives, initial encounter T39.2X5D Adverse effect of pyrazolone derivatives, subsequent encounter T39.2X5S Adverse effect of pyrazolone derivatives, sequela T39.315A Adverse effect of propionic acid derivatives, initial encounter T39.315D Adverse effect of propionic acid derivatives, subsequent encounter T39.315S Adverse effect of propionic acid derivatives, sequela T39.395A Adverse effect of other nonsteroidal anti-inflammatory drugs [NSAID], initial encounter T39.395D Adverse effect of other nonsteroidal anti-inflammatory drugs [NSAID], subsequent encounter T39.395S Adverse effect of other nonsteroidal anti-inflammatory drugs [NSAID], sequela T39.4X5A Adverse effect of antirheumatics, not elsewhere classified, initial encounter T39.4X5D Adverse effect of antirheumatics, not elsewhere classified, subsequent encounter T39.4X5S Adverse effect of antirheumatics, not elsewhere classified, sequela T39.8X5A Adverse effect of other nonopioid analgesics and antipyretics, not elsewhere classified, initial encounter T39.8X5D Adverse effect of other nonopioid analgesics and antipyretics, not elsewhere classified, subsequent encounter T39.8X5S Adverse effect of other nonopioid analgesics and antipyretics, not elsewhere classified, sequela T44.3X5A Adverse effect of other parasympatholytics [anticholinergics and antimuscarinics] and spasmolytics, initial encounter T44.3X5D Adverse effect of other parasympatholytics [anticholinergics and antimuscarinics] and spasmolytics, subsequent encounter T44.3X5S Adverse effect of other parasympatholytics [anticholinergics and antimuscarinics] and spasmolytics, sequela T44.4X5A Adverse effect of predominantly alpha-adrenoreceptor agonists, initial encounter T44.4X5D Adverse effect of predominantly alpha-adrenoreceptor agonists, subsequent encounter T44.4X5S Adverse effect of predominantly alpha-adrenoreceptor agonists, sequela T44.5X5A Adverse effect of predominantly beta-adrenoreceptor agonists, initial encounter T44.5X5D Adverse effect of predominantly beta-adrenoreceptor agonists, subsequent encounter T44.5X5S Adverse effect of predominantly beta-adrenoreceptor agonists, sequela T44.6X5A Adverse effect of alpha-adrenoreceptor antagonists, initial encounter T44.6X5D Adverse effect of alpha-adrenoreceptor antagonists, subsequent encounter T44.6X5S Adverse effect of alpha-adrenoreceptor antagonists, sequela T44.7X5A Adverse effect of beta-adrenoreceptor antagonists, initial encounter T44.7X5D Adverse effect of beta-adrenoreceptor antagonists, subsequent encounter T44.7X5S Adverse effect of beta-adrenoreceptor antagonists, sequela T44.8X5A Adverse effect of centrally-acting and adrenergic-neuron-blocking agents, initial encounter T44.8X5D Adverse effect of centrally-acting and adrenergic-neuron-blocking agents, subsequent encounter T44.8X5S Adverse effect of centrally-acting and adrenergic-neuron-blocking agents, sequela T44.995A Adverse effect of other drug primarily affecting the autonomic nervous system, initial encounter T44.995D Adverse effect of other drug primarily affecting the autonomic nervous system, subsequent encounter T44.995S Adverse effect of other drug primarily affecting the autonomic nervous system, sequela T45.0X5A Adverse effect of antiallergic and antiemetic drugs, initial encounter T45.0X5D Adverse effect of antiallergic and antiemetic drugs, subsequent encounter T45.0X5S Adverse effect of antiallergic and antiemetic drugs, sequela T45.1X5A Adverse effect of antineoplastic and immunosuppressive drugs, initial encounter T45.1X5D Adverse effect of antineoplastic and immunosuppressive drugs, subsequent encounter T45.1X5S Adverse effect of antineoplastic and immunosuppressive drugs, sequela T45.2X5A Adverse effect of vitamins, initial encounter T45.2X5D Adverse effect of vitamins, subsequent encounter T45.2X5S Adverse effect of vitamins, sequela T45.3X5A Adverse effect of enzymes, initial encounter T45.3X5D Adverse effect of enzymes, subsequent encounter T45.3X5S Adverse effect of enzymes, sequela T45.4X5A Adverse effect of iron and its compounds, initial encounter T45.4X5D Adverse effect of iron and its compounds, subsequent encounter T45.4X5S Adverse effect of iron and its compounds, sequela T45.515A Adverse effect of anticoagulants, initial encounter T45.515D Adverse effect of anticoagulants, subsequent encounter T45.515S Adverse effect of anticoagulants, sequela T45.525A Adverse effect of antithrombotic drugs, initial encounter T45.525D Adverse effect of antithrombotic drugs, subsequent encounter T45.525S Adverse effect of antithrombotic drugs, sequela T45.615A Adverse effect of thrombolytic drugs, initial encounter T45.615D Adverse effect of thrombolytic drugs, subsequent encounter T45.615S Adverse effect of thrombolytic drugs, sequela T45.625A Adverse effect of hemostatic drug, initial encounter T45.625D Adverse effect of hemostatic drug, subsequent encounter T45.625S Adverse effect of hemostatic drug, sequela T45.695A Adverse effect of other fibrinolysis-affecting drugs, initial encounter T45.695D Adverse effect of other fibrinolysis-affecting drugs, subsequent encounter T45.695S Adverse effect of other fibrinolysis-affecting drugs, sequela T45.7X5A Adverse effect of anticoagulant antagonists, vitamin K and other coagulants, initial encounter T45.7X5D Adverse effect of anticoagulant antagonists, vitamin K and other coagulants, subsequent encounter T45.7X5S Adverse effect of anticoagulant antagonists, vitamin K and other coagulants, sequela T45.8X5A Adverse effect of other primarily systemic and hematological agents, initial encounter T45.8X5D Adverse effect of other primarily systemic and hematological agents, subsequent encounter T45.8X5S Adverse effect of other primarily systemic and hematological agents, sequela T45.AX5A Adverse effect of immune checkpoint inhibitors and immunostimulant drugs, initial encounter T45.AX5D Adverse effect of immune checkpoint inhibitors and immunostimulant drugs, subsequent encounter T45.AX5S Adverse effect of immune checkpoint inhibitors and immunostimulant drugs, sequela T46.0X5A Adverse effect of cardiac-stimulant glycosides and drugs of similar action, initial encounter T46.0X5D Adverse effect of cardiac-stimulant glycosides and drugs of similar action, subsequent encounter T46.0X5S Adverse effect of cardiac-stimulant glycosides and drugs of similar action, sequela T46.1X5A Adverse effect of calcium-channel blockers, initial encounter T46.1X5D Adverse effect of calcium-channel blockers, subsequent encounter T46.1X5S Adverse effect of calcium-channel blockers, sequela T46.2X5A Adverse effect of other antidysrhythmic drugs, initial encounter T46.2X5D Adverse effect of other antidysrhythmic drugs, subsequent encounter T46.2X5S Adverse effect of other antidysrhythmic drugs, sequela T46.3X5A Adverse effect of coronary vasodilators, initial encounter T46.3X5D Adverse effect of coronary vasodilators, subsequent encounter T46.3X5S Adverse effect of coronary vasodilators, sequela T46.4X5A Adverse effect of angiotensin-converting-enzyme inhibitors, initial encounter T46.4X5D Adverse effect of angiotensin-converting-enzyme inhibitors, subsequent encounter T46.4X5S Adverse effect of angiotensin-converting-enzyme inhibitors, sequela T46.5X5A Adverse effect of other antihypertensive drugs, initial encounter T46.5X5D Adverse effect of other antihypertensive drugs, subsequent encounter T46.5X5S Adverse effect of other antihypertensive drugs, sequela T46.6X5A Adverse effect of antihyperlipidemic and antiarteriosclerotic drugs, initial encounter T46.6X5D Adverse effect of antihyperlipidemic and antiarteriosclerotic drugs, subsequent encounter T46.6X5S Adverse effect of antihyperlipidemic and antiarteriosclerotic drugs, sequela T46.7X5A Adverse effect of peripheral vasodilators, initial encounter T46.7X5D Adverse effect of peripheral vasodilators, subsequent encounter T46.7X5S Adverse effect of peripheral vasodilators, sequela T46.8X5A Adverse effect of antivaricose drugs, including sclerosing agents, initial encounter T46.8X5D Adverse effect of antivaricose drugs, including sclerosing agents, subsequent encounter T46.8X5S Adverse effect of antivaricose drugs, including sclerosing agents, sequela T46.995A Adverse effect of other agents primarily affecting the cardiovascular system, initial encounter T46.995D Adverse effect of other agents primarily affecting the cardiovascular system, subsequent encounter T46.995S Adverse effect of other agents primarily affecting the cardiovascular system, sequela T47.0X5A Adverse effect of histamine H2-receptor blockers, initial encounter T47.0X5D Adverse effect of histamine H2-receptor blockers, subsequent encounter T47.0X5S Adverse effect of histamine H2-receptor blockers, sequela T47.1X5A Adverse effect of other antacids and anti-gastric-secretion drugs, initial encounter T47.1X5D Adverse effect of other antacids and anti-gastric-secretion drugs, subsequent encounter T47.1X5S Adverse effect of other antacids and anti-gastric-secretion drugs, sequela T47.2X5A Adverse effect of stimulant laxatives, initial encounter T47.2X5D Adverse effect of stimulant laxatives, subsequent encounter T47.2X5S Adverse effect of stimulant laxatives, sequela T47.3X5A Adverse effect of saline and osmotic laxatives, initial encounter T47.3X5D Adverse effect of saline and osmotic laxatives, subsequent encounter T47.3X5S Adverse effect of saline and osmotic laxatives, sequela T47.4X5A Adverse effect of other laxatives, initial encounter T47.4X5D Adverse effect of other laxatives, subsequent encounter T47.4X5S Adverse effect of other laxatives, sequela T47.5X5A Adverse effect of digestants, initial encounter T47.5X5D Adverse effect of digestants, subsequent encounter T47.5X5S Adverse effect of digestants, sequela T47.6X5A Adverse effect of antidiarrheal drugs, initial encounter T47.6X5D Adverse effect of antidiarrheal drugs, subsequent encounter T47.6X5S Adverse effect of antidiarrheal drugs, sequela T47.7X5A Adverse effect of emetics, initial encounter T47.7X5D Adverse effect of emetics, subsequent encounter T47.7X5S Adverse effect of emetics, sequela T47.8X5A Adverse effect of other agents primarily affecting gastrointestinal system, initial encounter T47.8X5D Adverse effect of other agents primarily affecting gastrointestinal system, subsequent encounter T47.8X5S Adverse effect of other agents primarily affecting gastrointestinal system, sequela T48.0X5A Adverse effect of oxytocic drugs, initial encounter T48.0X5D Adverse effect of oxytocic drugs, subsequent encounter T48.0X5S Adverse effect of oxytocic drugs, sequela T48.1X5A Adverse effect of skeletal muscle relaxants [neuromuscular blocking agents], initial encounter T48.1X5D Adverse effect of skeletal muscle relaxants [neuromuscular blocking agents], subsequent encounter T48.1X5S Adverse effect of skeletal muscle relaxants [neuromuscular blocking agents], sequela T48.295A Adverse effect of other drugs acting on muscles, initial encounter T48.295D Adverse effect of other drugs acting on muscles, subsequent encounter T48.295S Adverse effect of other drugs acting on muscles, sequela T48.3X5A Adverse effect of antitussives, initial encounter T48.3X5D Adverse effect of antitussives, subsequent encounter T48.3X5S Adverse effect of antitussives, sequela T48.4X5A Adverse effect of expectorants, initial encounter T48.4X5D Adverse effect of expectorants, subsequent encounter T48.4X5S Adverse effect of expectorants, sequela T48.5X5A Adverse effect of other anti-common-cold drugs, initial encounter T48.5X5D Adverse effect of other anti-common-cold drugs, subsequent encounter T48.5X5S Adverse effect of other anti-common-cold drugs, sequela T48.6X5A Adverse effect of antiasthmatics, initial encounter T48.6X5D Adverse effect of antiasthmatics, subsequent encounter T48.6X5S Adverse effect of antiasthmatics, sequela T48.995A Adverse effect of other agents primarily acting on the respiratory system, initial encounter T48.995D Adverse effect of other agents primarily acting on the respiratory system, subsequent encounter T48.995S Adverse effect of other agents primarily acting on the respiratory system, sequela T49.5X5A Adverse effect of ophthalmological drugs and preparations, initial encounter T49.5X5D Adverse effect of ophthalmological drugs and preparations, subsequent encounter T49.5X5S Adverse effect of ophthalmological drugs and preparations, sequela T50.0X5A Adverse effect of mineralocorticoids and their antagonists, initial encounter T50.0X5D Adverse effect of mineralocorticoids and their antagonists, subsequent encounter T50.0X5S Adverse effect of mineralocorticoids and their antagonists, sequela T50.1X5A Adverse effect of loop [high-ceiling] diuretics, initial encounter T50.1X5D Adverse effect of loop [high-ceiling] diuretics, subsequent encounter T50.1X5S Adverse effect of loop [high-ceiling] diuretics, sequela T50.2X5A Adverse effect of carbonic-anhydrase inhibitors, benzothiadiazides and other diuretics, initial encounter T50.2X5D Adverse effect of carbonic-anhydrase inhibitors, benzothiadiazides and other diuretics, subsequent encounter T50.2X5S Adverse effect of carbonic-anhydrase inhibitors, benzothiadiazides and other diuretics, sequela T50.3X5A Adverse effect of electrolytic, caloric and water-balance agents, initial encounter T50.3X5D Adverse effect of electrolytic, caloric and water-balance agents, subsequent encounter T50.3X5S Adverse effect of electrolytic, caloric and water-balance agents, sequela T50.4X5A Adverse effect of drugs affecting uric acid metabolism, initial encounter T50.4X5D Adverse effect of drugs affecting uric acid metabolism, subsequent encounter T50.4X5S Adverse effect of drugs affecting uric acid metabolism, sequela T50.5X5A Adverse effect of appetite depressants, initial encounter T50.5X5D Adverse effect of appetite depressants, subsequent encounter T50.5X5S Adverse effect of appetite depressants, sequela T50.7X5A Adverse effect of analeptics and opioid receptor antagonists, initial encounter T50.7X5D Adverse effect of analeptics and opioid receptor antagonists, subsequent encounter T50.7X5S Adverse effect of analeptics and opioid receptor antagonists, sequela T50.8X5A Adverse effect of diagnostic agents, initial encounter T50.8X5D Adverse effect of diagnostic agents, subsequent encounter T50.8X5S Adverse effect of diagnostic agents, sequela T50.995A Adverse effect of other drugs, medicaments and biological substances, initial encounter T50.995D Adverse effect of other drugs, medicaments and biological substances, subsequent encounter T50.995S Adverse effect of other drugs, medicaments and biological substances, sequela T50.A15A Adverse effect of pertussis vaccine, including combinations with a pertussis component, initial encounter T50.A15D Adverse effect of pertussis vaccine, including combinations with a pertussis component, subsequent encounter T50.A15S Adverse effect of pertussis vaccine, including combinations with a pertussis component, sequela T50.A25A Adverse effect of mixed bacterial vaccines without a pertussis component, initial encounter T50.A25D Adverse effect of mixed bacterial vaccines without a pertussis component, subsequent encounter T50.A25S Adverse effect of mixed bacterial vaccines without a pertussis component, sequela T50.A95A Adverse effect of other bacterial vaccines, initial encounter T50.A95D Adverse effect of other bacterial vaccines, subsequent encounter T50.A95S Adverse effect of other bacterial vaccines, sequela T50.B95A Adverse effect of other viral vaccines, initial encounter T50.B95D Adverse effect of other viral vaccines, subsequent encounter T50.B95S Adverse effect of other viral vaccines, sequela T50.Z15A Adverse effect of immunoglobulin, initial encounter T50.Z15D Adverse effect of immunoglobulin, subsequent encounter T50.Z15S Adverse effect of immunoglobulin, sequela T50.Z95A Adverse effect of other vaccines and biological substances, initial encounter T50.Z95D Adverse effect of other vaccines and biological substances, subsequent encounter T50.Z95S Adverse effect of other vaccines and biological substances, sequela T78.01XA Anaphylactic reaction due to peanuts, initial encounter T78.01XD Anaphylactic reaction due to peanuts, subsequent encounter T78.01XS Anaphylactic reaction due to peanuts, sequela T78.02XA Anaphylactic reaction due to shellfish (crustaceans), initial encounter T78.02XD Anaphylactic reaction due to shellfish (crustaceans), subsequent encounter T78.02XS Anaphylactic reaction due to shellfish (crustaceans), sequela T78.03XA Anaphylactic reaction due to other fish, initial encounter T78.03XD Anaphylactic reaction due to other fish, subsequent encounter T78.03XS Anaphylactic reaction due to other fish, sequela T78.04XA Anaphylactic reaction due to fruits and vegetables, initial encounter T78.04XD Anaphylactic reaction due to fruits and vegetables, subsequent encounter T78.04XS Anaphylactic reaction due to fruits and vegetables, sequela T78.05XA Anaphylactic reaction due to tree nuts and seeds, initial encounter T78.05XD Anaphylactic reaction due to tree nuts and seeds, subsequent encounter T78.05XS Anaphylactic reaction due to tree nuts and seeds, sequela T78.06XA Anaphylactic reaction due to food additives, initial encounter T78.06XD Anaphylactic reaction due to food additives, subsequent encounter T78.06XS Anaphylactic reaction due to food additives, sequela T78.07XA Anaphylactic reaction due to milk and dairy products, initial encounter T78.07XD Anaphylactic reaction due to milk and dairy products, subsequent encounter T78.07XS Anaphylactic reaction due to milk and dairy products, sequela T78.08XA Anaphylactic reaction due to eggs, initial encounter T78.08XD Anaphylactic reaction due to eggs, subsequent encounter T78.08XS Anaphylactic reaction due to eggs, sequela T78.09XA Anaphylactic reaction due to other food products, initial encounter T78.09XD Anaphylactic reaction due to other food products, subsequent encounter T78.09XS Anaphylactic reaction due to other food products, sequela T78.1XXA Other adverse food reactions, not elsewhere classified, initial encounter T78.1XXD Other adverse food reactions, not elsewhere classified, subsequent encounter T78.1XXS Other adverse food reactions, not elsewhere classified, sequela Z88.0 Allergy status to penicillin Z88.1 Allergy status to other antibiotic agents Z88.2 Allergy status to sulfonamides Z88.3 Allergy status to other anti-infective agents Z88.4 Allergy status to anesthetic agent Z88.5 Allergy status to narcotic agent Z88.6 Allergy status to analgesic agent Z88.7 Allergy status to serum and vaccine Z88.8 Allergy status to other drugs, medicaments and biological substances Z91.010 Allergy to peanuts Z91.011 Allergy to milk products Z91.012 Allergy to eggs Z91.013 Allergy to seafood Z91.014 Allergy to mammalian meats Z91.018 Allergy to other foods ICD-10 Codes That Are Not Covered XX000

Revision History Information

Revision History Date Revision History Number Revision History Explanation 01/01/2025 R16 Article revised and published on 01/30/2025 effective for dates of service on and after 01/01/2025 to reflect the Annual HCPCS/CPT Code Updates. For the following CPT codes short descriptions were changed. For group 1 the codes 95004, 95017, 95018, 95024, 95027 and 95028. For group 2 the code 95070 and for group 3 the codes 95044, 95052, 95056, 95060 and 95065. 10/01/2024 R15 Article revised and published on 10/24/2024 effective for dates of service on and after 10/01/2024 to reflect the Annual ICD-10-CM Code Updates. The following ICD-10-CM codes have been added to the ‘ICD-10-CM Codes that Support Medical Necessity’ section for ‘Group 4 Codes’: T45.AX5A, T45.AX5D and T45.AX5S. 08/01/2024 R14 Article revised and published on 08/01/2024 effective for dates of service on and after 06/10/2024. The following ICD-10 codes have been added: J30.9 and R05.3 to Group 1 and J30.1, J30.2, J30.81, J30.89, J30.9, and R05.3 to Group 2. 07/01/2024 R13 Article revised and published on 07/18/2024 effective for dates of service on and after 07/01/2024. For the following CPT code, the short description was changed: 95024. This revision is in response to the July CPT/HCPCS quarterly update. 04/01/2024 R12 Article revised and published on 04/04/2024 effective for dates of service on and after 04/01/2024 to reflect the April Quarterly CPT/HCPCS Code Update. For the following CPT/HCPCS code either the short description and/or the long description was changed: 95024. Depending on which description is used in this article, there may not be any change in how the code displays in the document. 01/13/2023 R11 Article revised and published on 02/23/2023 effective for dates of service on and after 01/13/2023 in response to an inquiry. The following ICD-10-CM codes have been added to the ‘ICD-10-CM Codes that Support Medical Necessity’ section for ‘Group 1 Codes’ and ‘Group 2 Codes’: J30.5, J32.3, J45.901, J45.902, J45.909, T78.40XA, T78.40XD, T78.40XS, Z91.010, Z91.011, Z91.012, Z91.013, Z91.014, and Z91.018. 01/01/2022 R10 Article revised and published on 02/17/2022 effective for dates of service on and after 09/03/2021. CPT codes 0165U and 0178U have been added to the ‘CPT/HCPCS Codes’ section for ‘Group 1 Codes’ and to the ‘ICD-10-CM Codes that Support Medical Necessity’ section for ‘Group 1 Paragraph’. 01/01/2022 R9 Article revised and published on 1/20/2022 effective for dates of service on and after 01/01/2022 to reflect the Annual HCPCS/CPT Code Updates. For the following CPT code either the short description and/or the long description was changed. Depending on which description is used in this article, there may not be any change in how the code displays: 95070 in Group 2 Codes. 07/11/2021 R8 Article revised and published on 11/18/2021 effective for dates of service on and after 07/11/2021 in response to an inquiry. The following ICD-10-CM codes have been added to the ‘ICD-10-CM Codes that Support Medical Necessity’ section for ‘Group 4 Codes’: T36.0X5A, T36.0X5D, T36.0X5S, T36.1X5A, T36.1X5D, T36.1X5S, T36.2X5A, T36.2X5D, T36.2X5S, T36.3X5A, T36.3X5D, T36.3X5S, T36.4X5A, T36.4X5D, T36.4X5S, T36.5X5A, T36.5X5D, T36.5X5S, T36.6X5A, T36.6X5D, T36.6X5S, T36.7X5A, T36.7X5D, T36.7X5S, T36.8X5A, T36.8X5D, T36.8X5S, T37.0X5A, T37.0X5D, T37.0X5S, T37.1X5A, T37.1X5D, T37.1X5S, T37.2X5A, T37.2X5D, T37.2X5S, T37.3X5A, T37.3X5D, T37.3X5S, T37.4X5A, T37.4X5D, T37.4X5S, T37.5X5A, T37.5X5D, T37.5X5S, T37.8X5A, T37.8X5D, T37.8X5S, T38.0X5A, T38.0X5D, T38.0X5S, T38.1X5A, T38.1X5D, T38.1X5S, T38.2X5A, T38.2X5D, T38.2X5S, T38.3X5A, T38.3X5D, T38.3X5S, T38.4X5A, T38.4X5D, T38.4X5S, T38.5X5A, T38.5X5D, T38.5X5S, T38.6X5A, T38.6X5D, T38.6X5S, T38.7X5A, T38.7X5D, T38.7X5S, T38.815A, T38.815D, T38.815S, T38.895A, T38.895D, T38.895S, T38.995A, T38.995D, T38.995S, T39.015A, T39.015D, T39.015S, T39.095A, T39.095D, T39.095S, T39.1X5A, T39.1X5D, T39.1X5S, T39.2X5A, T39.2X5D, T39.2X5S, T39.315A, T39.315D, T39.315S, T39.395A, T39.395D, T39.395S, T39.4X5A, T39.4X5D, T39.4X5S, T39.8X5A, T39.8X5D, T39.8X5S, T44.3X5A, T44.3X5D, T44.3X5S, T44.4X5A, T44.4X5D, T44.4X5S, T44.5X5A, T44.5X5D, T44.5X5S, T44.6X5A, T44.6X5D, T44.6X5S, T44.7X5A, T44.7X5D, T44.7X5S, T44.8X5A, T44.8X5D, T44.8X5S, T44.995A, T44.995D, T44.995S, T45.0X5A, T45.0X5D, T45.0X5S, T45.1X5A, T45.1X5D, T45.1X5S, T45.2X5A, T45.2X5D, T45.2X5S, T45.3X5A, T45.3X5D, T45.3X5S, T45.4X5A, T45.4X5D, T45.4X5S, T45.515A, T45.515D, T45.515S, T45.525A, T45.525D, T45.525S, T45.615A, T45.615D, T45.615S, T45.625A, T45.625D, T45.625S, T45.695A, T45.695D, T45.695S, T45.7X5A, T45.7X5D, T45.7X5S, T45.8X5A, T45.8X5D, T45.8X5S, T46.0X5A, T46.0X5D, T46.0X5S, T46.1X5A, T46.1X5D, T46.1X5S, T46.2X5A, T46.2X5D, T46.2X5S, T46.3X5A, T46.3X5D, T46.3X5S, T46.4X5A, T46.4X5D, T46.4X5S, T46.5X5A, T46.5X5D, T46.5X5S, T46.6X5A, T46.6X5D, T46.6X5S, T46.7X5A, T46.7X5D, T46.7X5S, T46.8X5A, T46.8X5D, T46.8X5S, T46.995A, T46.995D, T46.995S, T47.0X5A, T47.0X5D, T47.0X5S, T47.1X5A, T47.1X5D, T47.1X5S, T47.2X5A, T47.2X5D, T47.2X5S, T47.3X5A, T47.3X5D, T47.3X5S, T47.4X5A, T47.4X5D, T47.4X5S, T47.5X5A, T47.5X5D, T47.5X5S, T47.6X5A, T47.6X5D, T47.6X5S, T47.7X5A, T47.7X5D, T47.7X5S, T47.8X5A, T47.8X5D, T47.8X5S, T48.0X5A, T48.0X5D, T48.0X5S, T48.1X5A, T48.1X5D, T48.1X5S, T48.295A, T48.295D, T48.295S, T48.3X5A, T48.3X5D, T48.3X5S, T48.4X5A, T48.4X5D, T48.4X5S, T48.5X5A, T48.5X5D, T48.5X5S, T48.6X5A, T48.6X5D, T48.6X5S, T48.995A, T48.995D, T48.995S, T49.5X5A, T49.5X5D, T49.5X5S, T50.0X5A, T50.0X5D, T50.0X5S, T50.1X5A, T50.1X5D, T50.1X5S, T50.2X5A, T50.2X5D, T50.2X5S, T50.3X5A, T50.3X5D, T50.3X5S, T50.4X5A, T50.4X5D, T50.4X5S, T50.5X5A, T50.5X5D, T50.5X5S, T50.7X5A, T50.7X5D, T50.7X5S, T50.8X5A, T50.8X5D, T50.8X5S, T50.A15A, T50.A15D, T50.A15S, T50.A25A, T50.A25D, T50.A25S, T50.A95A, T50.A95D, T50.A95S, T50.B95A, T50.B95D, T50.B95S, T50.Z15A, T50.Z15D, T50.Z15S, T50.Z95A, T50.Z95D, T50.Z95S, T50.995A, T50.995D, T50.995S, T78.1XXA, T78.1XXD, and T78.1XXS. 07/11/2021 R7 Article revised and published on 10/21/2021 effective for dates of service on and after 07/11/2021 in response to an inquiry. The following ICD-10 codes have been added to the ‘ICD-10-CM Codes that Support Medical Necessity’ section for ‘Group 4 Codes’: Z88.0, Z88.1, Z88.2, Z88.3, Z88.4, Z88.5, Z88.6, Z88.7, Z88.8, Z91.010, Z91.011, Z91.012, Z91.013, Z91.014, and Z91.018. 07/11/2021 R6 Draft article posted on 01/14/2021. Article effective for dates of service on and after 07/11/2021. 10/01/2020 R5 Article revised and published on 10/01/2020 effective for dates of service on and after 10/01/2020 to reflect the Annual ICD-10-CM Code Updates. The following ICD-10-CM code(s) have undergone a descriptor change: Z88.1, Z88.2, Z88.3, Z88.4, Z88.5, Z88.6, Z88.7, Z88.8, Z88.9 for Group 1 Codes and Z88.1, Z88.2, Z88.3, Z88.4, Z88.5, Z88.6, Z88.7, Z88.8 for Group 4 Codes. Minor formatting changes made through the coding section. 07/01/2020 R4 Article revised and published on 07/30/2020 effective for dates of service on and after 07/01/2020, CPT code 0178U has been added to CPT code group 1 and ICD-10 group 2 paragraph. In addition, under CPT/HCPCS codes, Group 1 Codes, 0165U has a descriptor change due to July HCPCS code updates. 07/01/2020 R3 Article revised and published on 06/25/2020 effective for dates of service on and after 07/01/2020, as a non-discretionary update to remove CPT code 86001 from Group 2 CPT codes group. Minor formatting changes have been made. 04/01/2020 R2 Article revised and published on 04/30/2020 effective for dates of service on and after 04/01/2020, consistent with CMS Change Request 11681. CPT code 0165U was added to code group 1 and to the ICD-10 group 2 paragraph. Formatting changes have also been made. 10/17/2019 R1 Article revised and published on 10/17/2019 effective for dates of service on and after 10/01/2019 to reflect the Annual ICD-10-CM Code Updates. The following ICD-10-CM code has undergone a descriptor change: J44.0. An asterisk has been added next to Z86.19 in ICD-10 Code Group 2 code table and the note regarding this code has been moved from the Group 2 paragraph to the asterisk explanation. Please note, system changes have been made to our articles in response to CMS Change Request 10901. The Coding Section has been reordered and new sections for CPT/HCPCS Modifiers and Other Coding Information have been added.