ICD-10 Coding for Acetaminophen Allergy(T39.1X5A, T78.4XXA, T78.2XXA, L50.0)
Complete ICD-10-CM coding and documentation guide for Acetaminophen Allergy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Acetaminophen Allergy
T39.1Primary Range
Poisoning by, adverse effect of and underdosing of 4-Aminophenol derivatives
This range includes codes for adverse effects and poisoning by acetaminophen, which is a 4-aminophenol derivative.
Anaphylactic shock and allergy, unspecified
These codes are used for documenting anaphylactic reactions and unspecified allergies, which can occur due to acetaminophen.
Allergy status to analgesic agent
This code is used to indicate a patient's allergy status to analgesics, including acetaminophen.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| T39.1X5A | Adverse effect of 4-aminophenol derivatives (acetaminophen), initial encounter | Use when documenting an adverse effect of acetaminophen, such as an allergic reaction. |
|
| T78.4XXA | Allergy, unspecified, initial encounter | Use for unspecified allergic reactions to acetaminophen. |
|
| T78.2XXA | Anaphylactic shock, initial encounter | Use for anaphylactic reactions to acetaminophen. |
|
| L50.0 | Allergic urticaria | Use for urticaria reactions to acetaminophen. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for acetaminophen allergy
Essential facts and insights about Acetaminophen Allergy
Primary ICD-10-CM Codes for acetaminophen allergy
Decision Criteria
clinical Criteria
- Adverse reaction following correct administration of acetaminophen
Applicable To
- Adverse effect of acetaminophen
Excludes
- Poisoning by acetaminophen
Clinical Validation Requirements
- Documented adverse reaction following correct administration of acetaminophen
Code-Specific Risks
- Confusion with poisoning codes if the drug was taken incorrectly.
Coding Notes
- Ensure documentation specifies the adverse effect was due to correct administration.
T78.4XXA - Allergy, unspecified, initial encounter
Use for unspecified allergic reactions to acetaminophen.
Applicable To
- Allergic reaction NOS
Excludes
- Anaphylactic shock
Clinical Validation Requirements
- Symptoms consistent with an allergic reaction, such as rash or swelling.
Coding Notes
Ensure documentation specifies the allergic reaction was due to acetaminophen.
T78.2XXA - Anaphylactic shock, initial encounter
Use for anaphylactic reactions to acetaminophen.
Applicable To
- Anaphylaxis due to drug
Excludes
- Allergy, unspecified
Clinical Validation Requirements
- Symptoms of anaphylaxis such as hypotension, bronchospasm.
Coding Notes
Ensure documentation specifies anaphylaxis was due to acetaminophen.
L50.0 - Allergic urticaria
Use for urticaria reactions to acetaminophen.
Applicable To
- Hives due to allergy
Excludes
- Non-allergic urticaria
Clinical Validation Requirements
- Presence of hives following acetaminophen administration.
Coding Notes
Ensure documentation specifies urticaria was due to acetaminophen.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Allergy status to analgesic agent
Z88.6Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Poisoning by 4-aminophenol derivatives, accidental (unintentional), initial encounter
T39.1X1AAnaphylactic shock, initial encounter
T78.2XXAAllergy, unspecified, initial encounter
T78.4XXAUrticaria, unspecified
L50.9Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Acetaminophen Allergy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code T39.1X5A.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials due to insufficient detail.
Mitigation Strategy
Use specific terms like 'urticaria' or 'anaphylaxis'.
Impact
Reimbursement: May lead to claim denials due to incomplete coding., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate representation of patient condition.
Mitigation Strategy
Always pair with a reaction code and T39.1X5A.
Impact
Reimbursement: Incorrect DRG assignment affecting reimbursement., Compliance: Potential audit issues for incorrect code usage., Data Quality: Misleading clinical data affecting patient care.
Mitigation Strategy
Use T39.1X5A for adverse effects, not poisoning codes.
Impact
Failure to pair reaction codes with adverse effect codes.
Mitigation Strategy
Implement coding audits to ensure correct code combinations.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Acetaminophen Allergy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Acetaminophen Allergy
Use these documentation templates to ensure complete and accurate documentation for Acetaminophen Allergy. These templates include all required elements for proper coding and billing.
Acute urticaria after acetaminophen
Specialty: Emergency MedicineRequired Elements
- Reaction type and timing
- Drug name and dose
- Exclusion of other causes
- Treatment provided
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Anaphylaxis after acetaminophen
Specialty: Allergy and ImmunologyRequired Elements
- Symptoms of anaphylaxis
- Drug name and dose
- Immediate treatment
- Follow-up plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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