T80.52XA
T80.52XA — Anaphylactic reaction due to vaccination, initial encounter
Billable / specific codeICD-10-CM
T80.52XA is a billable, specific ICD-10-CM code for anaphylactic reaction due to vaccination, 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 T80
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
T80.52XA 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
T80.52XA is named in 14 Medicare coverage policies — 14 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56538Billing and Coding: Allergen Immunotherapy
- A56558Billing and Coding: Allergy Testing
- A56612Billing and Coding: CT of the Head
- A56781Billing and Coding: Transthoracic Echocardiography (TTE)
Related codes at this level
Codes that share T80.52. If T80.52XA is not quite right, the correct code is usually one of these.
Questions about T80.52XA
- Is T80.52XA a billable ICD-10-CM code?
- Yes. T80.52XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T80.52XA sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Complications of surgical and medical care, not elsewhere classified (T80-T88).