February 28, 2019
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!
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.