Food Allergy and ICD-9 coding

[ajasfolks2]

Anyone have handy a current copy of the ICD9 coding book?

What I'm looking for is the diagnoses codes for food allergy.

For now, specifically peanut.

And the modifier too.

Should be 995 ish?

Also, any related V codes.


~ ~ ~

One of the things I'm looking for is --

is there a modifier on Peanut Allergy that indicates delineation for

INGESTION ONLY

and one for

INGESTION AND CONTACT


~ ~ ~

[GoingNuts]

I emailed this to myself so I can check at work tomorrow.  There has to be a copy around somewhere.

[rebekahc]

V15.01 = personal history of allergy to peanuts. In searching online I can't find any designation more specific to that.

http://www.icd9data.com/2011/Volume1/V01-V91/V10-V19/V15/default.htm

995.61 = anaphylaxis due to peanuts

http://icd9cm.chrisendres.com/index.php

[ajasfolks2]

Thank you, both!

Now, is there any additional modifier as to the means of transport of allergen into body?

Again, what I'm trying to determine is

contact and ingestion (either, or, both)

actually GIVEN an ICD-9 modifier?


For starters, anyway.

Today.   

Certainly this thread invites anyone with specific professional medical training to add any comments or questions.

And anyone else, for that matter.

[rebekahc]

Well, I couldn't find any additional modifiers unless you added one for contact dermatitis or something. But I think that would not be standard and would just be a separate dx?

ETA:  did some more searching. The article is older, but might give you a starting point to use in one of those other links I posted earlier.

http://www.fortherecordmag.com/archives/ftr_01212008p25.shtml

[ajasfolks2]

. . .  just in case there have been UPDATES to the last-published version . . . things that would likely come to MD and insurance offices . . . beyond what might be viewable at online sites (such as at links provided above). . .

[rebekahc]

One of those links had an option to translate into newer versions...

[ajasfolks2]

As to dermatitis and urticaria --

we should examine those Dx (diagnoses) as well with all modifiers.

Anything else directly related?

Recapping:

All the anaphylaxis and related codes
All the food allergy and related codes
All the contact dermatitis and related codes
All the urticaria and related codes


AND all the V- codes in those same areas.

What have we missed?

[rebekahc]

That last link I added had other codes as well - allergic diarrhea and allergic colitis among others.

[ajasfolks2]

That article is helpful!!

I'm wondering too if I should be trying to find modifier for

INHALATION  reaction as well, so far as  peanut ana.

~ ~ ~

[GoingNuts]

Hmmm, didn't have as much time to delve as I would have liked, but yes, 995.61 for anaphylaxis to peanut.  "Food" in general is 995.60.

Under Anaphylactic shock or reaction, there was also purpura with a code of 287.0.

I didn't see any modifiers for route of ingestion, but like I said, I didn't have much time to delve.

If there's more time tomorrow, I'll check the asthma, urticaria and contact derm. 

I don't know what your purpose is wrt to this research, but as I was looking at the books it really hit me how under-diagnosed anaphylaxis probably is. 

Maybe that's your point, LOL. 

ETA:  Interestingly, no code for idiopathic.

[ajasfolks2]

What's interesting to me is that there is nothing so far as modifier which addresses the allergen route of exposure.

There is a growing practice by laypeople, parents, educators (even as part of their 504 eval), and even medical community to attempt to describe or classify those with life-threatening food allergy (risk of anaphylaxis, properly diagnosed by physician with adequate training and certification) as having the condition TO A DEGREE --

"severe"

"more severe"

"most severe"

"exquisite"


AND often also attaching to that a qualifier as to the mode of allergen contact that is responsible for the reaction(s):  skin contact, ingestion -- residue or actual food --, inhalant, aerisolized are just some of the verbiage being used (not saying necessarily correctly)


However, there sure doesn't seem to be any diagnosis codes or instruction to support this.

Just stating the facts.  No opinions either way as to level of "life-threat" and allergy.

Thoughts anyone?

[CMdeux]

Yeah-- it's an oversight.

Because I'm pretty sensitive to shellfish.  But not like DD is to peanuts.

It's a huge functional difference in terms of day-to-day management, and several allergists now have said that she is, by virtue of her history, a "poor risk" even for SPT.

I'm guessing that ought to be in a different category clinically. 

[ajasfolks2]

See, though, there has to be meaningful buy-in from the medical community generally to affect change of the ICD-9 codes, if I recall.  (Though I don't have official info into this thread as to HOW and WHY and WHEN those diagnosis codes are officially changed -- would like to have that here as well.)

WRT the LTFA physician-community there is a great deal of disparity and disagreement as to linking mode of allergen ingestion and reaction cause (beyond true EATING of the FOOD) . . . not to mention the problem with the INVISIBILITY of allergen residue and the lack of ability to truly test after reaction to KNOW what the body reacted or anaphylaxed to.

[GoingNuts]

Absolutely no time to check into it today, and I won't be back at work until Monday.  Sorry, I've failed you.