T78.05XA — Anaphylactic reaction due to tree nuts and seeds, initial encounter
T78.05XA is a billable, specific ICD-10-CM code for anaphylactic reaction due to tree nuts and seeds, initial encounter. It is valid for submission on a claim.
7th character "A" — initial encounter
The appropriate 7th character is to be added to each code from category T78
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- anaphylactic reaction due to peanuts (T78.01)
Risk adjustment
T78.05XA 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
T78.05XA is named in 26 Medicare coverage policies — 26 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
- A56612Billing and Coding: CT of the Head
Related codes at this level
Codes that share T78.05. If T78.05XA is not quite right, the correct code is usually one of these.
Questions about T78.05XA
- Is T78.05XA a billable ICD-10-CM code?
- Yes. T78.05XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T78.05XA 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).