T78.1

T78.1: Other adverse food reactions, not elsewhere classified

Non-billable headerICD-10-CM

T78.1 is a non-billable header ICD-10-CM code for other adverse food reactions, not elsewhere classified. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.

This code requires a 7th character

The appropriate 7th character is to be added to each code from category T78

A: initial encounter
D: subsequent encounter
S: sequela

Excludes1: never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

anaphylactic reaction or shock due to adverse food reaction (T78.0-)
anaphylactic reaction due to food (T78.0-)
bacterial food borne intoxications (A05.-)

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.

allergic and dietetic gastroenteritis and colitis (K52.29)
allergic rhinitis due to food (J30.5)
dermatitis due to food in contact with skin (L23.6, L24.6, L25.4)
dermatitis due to ingested food (L27.2)
food protein-induced enterocolitis syndrome (K52.21)
food protein-induced enteropathy (K52.22)

Use additional code

Add a secondary code to capture the detail described below.

code to identify the type of reaction, if applicable

Excludes2 inherited from the categories above T78.1

Not part of this code, but both may be coded when both are present.

Written on T78: Adverse effects, not elsewhere classified

complications of surgical and medical care NEC (T80-T88)

Other codes that can never be billed with T78.1

Their own Excludes1 notes name this code, so the conflict is not listed above.

T78.110Other adverse food reactions due to milk and dairy products with tolerance to baked milk
T78.110AOther adverse food reactions due to milk and dairy products with tolerance to baked milk, initial encounter
T78.110DOther adverse food reactions due to milk and dairy products with tolerance to baked milk, subsequent encounter
T78.110SOther adverse food reactions due to milk and dairy products with tolerance to baked milk, sequela
T78.111Other adverse food reaction due to milk and dairy products with reactivity to baked milk
T78.111AOther adverse food reaction due to milk and dairy products with reactivity to baked milk, initial encounter
T78.111DOther adverse food reaction due to milk and dairy products with reactivity to baked milk, subsequent encounter
T78.111SOther adverse food reaction due to milk and dairy products with reactivity to baked milk, sequela

Risk adjustment

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

Code history

Unchanged in every release from FY2024 to FY2027.

Code to one of these instead T78.1

3 child codes. Green means billable.