ICD-10 Coding for Shellfish Allergy(Z91.013, T78.02XA)
Complete ICD-10-CM coding and documentation guide for Shellfish Allergy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Shellfish Allergy
Z91.01-Z91.02Primary Range
Personal history of allergy to food, other
This range includes codes for documenting a patient's history of allergy to shellfish.
Anaphylactic reaction due to food
This range includes codes for acute anaphylactic reactions due to shellfish ingestion.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Z91.013 | Allergy to seafood | Use when documenting a patient's known allergy to shellfish without an active reaction. |
|
| T78.02XA | Anaphylactic reaction due to shellfish | Use for documenting an active anaphylactic reaction to shellfish. |
|
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 shellfish allergy
Essential facts and insights about Shellfish Allergy
Primary ICD-10-CM Codes for shellfish allergy
Decision Criteria
clinical Criteria
- Patient has a documented history of shellfish allergy.
Applicable To
- Crustacean allergy
- Mollusk allergy
Excludes
- Anaphylactic reaction due to shellfish (T78.02XA)
Clinical Validation Requirements
- Documented history of allergic reaction to shellfish
- Positive skin prick test or specific IgE test
Code-Specific Risks
- Incorrectly coding mollusk allergy under crustacean-specific codes
Coding Notes
- Ensure documentation specifies the type of shellfish and the diagnostic method used.
T78.02XA - Anaphylactic reaction due to shellfish
Use for documenting an active anaphylactic reaction to shellfish.
Applicable To
- Anaphylactic reaction to crustaceans
Excludes
- Allergy to seafood without anaphylaxis (Z91.013)
Clinical Validation Requirements
- Acute symptoms such as wheezing, angioedema, or hypotension following shellfish ingestion
- Confirmed shellfish ingestion prior to reaction
Coding Notes
Ensure acute reaction details are documented, including timing and severity.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Shellfish Allergy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z91.013.
Impact
Clinical: May lead to inappropriate management recommendations., Regulatory: Non-compliance with coding guidelines., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Always document the specific type of shellfish., Use templates that prompt for detailed information.
Impact
Reimbursement: Incorrect coding can lead to improper DRG assignment., Compliance: May result in compliance issues with coding standards., Data Quality: Affects the accuracy of patient records and data analytics.
Mitigation Strategy
Ensure documentation specifies the type of shellfish to use the correct code.
Impact
Lack of specificity in documenting the type of shellfish can lead to audit issues.
Mitigation Strategy
Use detailed templates and ensure all relevant information is captured.
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 Shellfish Allergy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Shellfish Allergy
Use these documentation templates to ensure complete and accurate documentation for Shellfish Allergy. These templates include all required elements for proper coding and billing.
Allergy Clinic Visit
Specialty: Allergy and ImmunologyRequired Elements
- Patient history of shellfish allergy
- Type of shellfish (crustacean or mollusk)
- Diagnostic tests performed
- Reaction details and management plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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