Billing and Coding: Allergy Testing (A58583)


Related Local Coverage Determination (LCD)
L38921-Allergy Testing


Contractor NameContract NumberStates
Novitas Solutions, Inc. 04111 - A and B MAC Colorado
04112 - A and B MAC Colorado
04211 - A and B MAC New Mexico
04212 - A and B MAC New Mexico
04311 - A and B MAC Oklahoma
04312 - A and B MAC Oklahoma
04411 - A and B MAC Texas
04412 - A and B MAC Texas
04911 - A and B MAC Colorado
New Mexico
Oklahoma
Texas
07101 - A and B MAC Arkansas
07102 - A and B MAC Arkansas
07201 - A and B MAC Louisiana
07202 - A and B MAC Louisiana
07301 - A and B MAC Mississippi
07302 - A and B MAC Mississippi
12101 - A and B MAC Delaware
12102 - A and B MAC Delaware
12201 - A and B MAC District of Columbia
12202 - A and B MAC District of Columbia
12301 - A and B MAC Maryland
12302 - A and B MAC Maryland
12401 - A and B MAC New Jersey
12402 - A and B MAC New Jersey
12501 - A and B MAC Pennsylvania
12502 - A and B MAC Pennsylvania
12901 - A and B MAC Delaware
District of Columbia
Maryland
New Jersey
Pennsylvania

Article Information

Article ID Number: A58583 Status: P-

Article Title: Billing and Coding: Allergy Testing

Original Article Effective Date:

Revision Effective Date:

Article Text:

This Billing and Coding Article provides billing and coding guidance for Local Coverage Determination (LCD) DL36241, Allergy Testing. Please refer to the LCD for reasonable and necessary requirements.

Coding Guidance

Notice
: It is not appropriate to bill Medicare for services that are not covered (as described by the entire LCD) as if they are covered. When billing for non-covered services, use the appropriate modifier.

Consistent with the related LCD, DL36241, CPT code 82785 Gammaglobulin [immunoglobulin]; IgE is not appropriate in most general allergy testing. Please refer to the LCD for details on medically reasonable and necessary guidelines.
It is not usually necessary to report CPT code 86003 Allergen specific IgE; quantitative or semiquantitative, crude allergen extract (in vitro testing) in addition to skin testing. Please see the related LCD for medically reasonable and necessary guidelines.

Documentation Requirements:

  1. All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
  2. Every page of the record must be legible and include appropriate patient identification information (e.g., complete name, dates of service[s]). The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care to the patient.
  3. The medical record must support the use of the selected ICD-10-CM code(s).
  4. The submitted CPT/HCPCS code must describe the service performed.
  5. Prior to performance of allergy testing, there must be evidence in the medical record that a history has been obtained, indicating the possible presence of allergy.
    • This history should support that attempts to narrow the area of investigation were taken so that the minimal number of necessary skin tests might deliver a diagnosis.
    • The history should support that the selection of antigens was based on the patient specific history and physician examination.
  1. The medical record must indicate which allergy test(s) were used, the interpretation(s), and measurement (in mm) of reaction size of both wheal and erythema response or a standardized grading system in vivo testing (as applicable).

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.

999Not 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:
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 codes support medical necessity and provide coverage for CPT codes: 86003, 86008, 95004, 95017, 95018, 95024, 95027, and 95028.

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
J30.81 Allergic rhinitis due to animal (cat) (dog) hair and dander
J30.89 Other allergic rhinitis
J31.0 Chronic rhinitis
J32.0 Chronic maxillary sinusitis
J32.1 Chronic frontal sinusitis
J32.2 Chronic ethmoidal 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
J45.991 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
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
T78.49XA 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

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 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
J31.0 Chronic rhinitis
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
J45.991 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
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
Z86.19 Personal history of other infectious and parasitic diseases

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 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
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

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 codes support medical necessity and provide coverage for CPT codes: 95076 and 95079 (Ingestion Challenge Testing).

L27.2 Dermatitis due to ingested food
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
ICD-10 Codes That Are Not Covered

XX000


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