L56.1

L56.1: Drug photoallergic response

Billable / specific codeICD-10-CM

L56.1 is a billable, specific ICD-10-CM code for drug photoallergic response. It is valid for submission on a claim.

Check L56.1 with the rest of the claim: free scrubber

Use additional code

Add a secondary code to capture the detail described below.

code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

L56.1 is named in 10 Medicare coverage policies: 10 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A60360Billing and Coding: Allergy Diagnostic Testing
A60361Billing and Coding: Allergy Diagnostic Testing
A60363Billing and Coding: Allergy Diagnostic Testing
A60364Billing and Coding: Allergy Diagnostic Testing

Alphabetic index entries that lead here

Response›photoallergic
Reaction›drug NEC›photoallergic

Code history

Unchanged in every release from FY2024 to FY2027.