T78.04XS — Anaphylactic reaction due to fruits and vegetables, sequela
T78.04XS is a billable, specific ICD-10-CM code for anaphylactic reaction due to fruits and vegetables, sequela. It is valid for submission on a claim.
7th character "S" — sequela
The appropriate 7th character is to be added to each code from category T78
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Excludes2 inherited from the categories above T78.04XS
Also inherited, and the opposite of Excludes1: these conditions are not part of T78.04XS, but a patient can have both, so you may code both.
Other codes that can never be billed with T78.04XS
These codes carry an Excludes1 note pointing at T78.04XS. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading T78.04XS alone.
- T75Other and unspecified effects of other external causes
Risk adjustment
T78.04XS does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
T78.04XS is named in 36 Medicare coverage policies — 36 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56558Billing and Coding: Allergy Testing
- A56558Billing and Coding: Allergy Testing
- A56558Billing and Coding: Allergy Testing
- A56559Billing and Coding: Allergy Skin Testing
Code history
T78.04XS has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share T78.04. If T78.04XS is not quite right, the correct code is usually one of these.
Questions about T78.04XS
- Is T78.04XS a billable ICD-10-CM code?
- Yes. T78.04XS is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T78.04XS sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Other and unspecified effects of external causes (T66-T78).