February 28, 2019

Question:
I have a question on billing for allergy testing. All this time, and for any patient getting allergy testing, ICD-10 code J30.1 (Allergic Rhinitis due to pollen) has been the diagnosis code we are using. At the recent KZA workshop ICD-10 code Z01.82 (encounter for allergy testing) could also be used, but not as a primary code? Did I understand that correctly. By the way, the workshop was fantastic and our staff will be going every year!

Answer:
Thank you so much for the kind words!  It was nice to meet you at the workshop.  Actually, ICD-10-CM guidelines state that Z01.82 (Encounter for allergy testing) may be used as a primary diagnosis code.  We would use this diagnosis code for all otolaryngic allergy testing CPT codes (eg, 95004, 95024).  The secondary diagnosis code would be the applicable J (Respiratory system) code for allergic rhinitis. Similarly, for the allergy shot encounter – ICD-10-CM guidelines state that Z51.6 (Encounter for desensitization to allergens) may be used as the primary diagnosis code for the shot visit (eg, 95115, 95117, 95165) and the J code as a secondary diagnosis code.  That said, you’ll need to check with your payors because some do not allow Z01.82 or Z51.6 as primary diagnosis codes.  In those instances, you’ll list the J diagnosis code(s) first.

*This response is based on the best information available as of 2/28/19.