icd 10 code for allergic rhinitis - J30.1

Allergic rhinitis due to pollen 

J30.1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
This is the American ICD-10-CM version of J30.1. Other international versions of ICD-10 J30.1 may differ.
Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.

Clinical Information

Allergic rhinitis caused by outdoor allergens.
Allergic rhinitis that occurs at the same time every year. It is characterized by acute conjunctivitis with lacrimation and itching, and regarded as an allergic condition triggered by specific allergens.
Each spring, summer, and fall, trees, weeds and grasses release tiny pollen grains into the air. Some of the pollen ends up in your nose and throat. This can trigger a type of allergy called hay fever.symptoms can include

        sneezing, often with a runny or clogged nose
        coughing and postnasal drip
        itching eyes, nose and throat
        dark circles under the eyes
        taking medicines, using nasal sprays and rinsing out your nose can relieve symptoms.

Allergy shots can help make you less sensitive to pollen and provide long-term relief. Seasonal variety of allergic rhinitis, marked by acute conjunctivitis with lacrimation and itching; regarded as an allergic condition triggered by specific allergens.

Applicable To

    Allergy NOS due to pollen
    Hay fever

Approximate Synonyms

Allergic rhinitis (nose congestion), pollen

The following ICD-10-CM Index entries contain back-references to ICD-10-CM J30.1:

    Allergy, allergic (reaction) (to) T78.40
    due to pollen J30.1
    grain J30.1
    grass (hay fever) (pollen) J30.1
    nasal, seasonal due to pollen J30.1
    pollen (any) (hay fever) J30.1
    primrose J30.1
    primula J30.1
    ragweed (hay fever) (pollen) J30.1
    rose (pollen) J30.1
    Senecio jacobae (pollen) J30.1
    tree (any) (hay fever) (pollen) J30.1
    inhalant (rhinitis) J30.89
    pollen J30.1

J30 Vasomotor and allergic rhinitis Includes: spasmodic rhinorrhea Excludes: allergic rhinitis with asthma (bronchial) (J45.909) rhinitis NOS (J31.0) J30.0 Vasomotor rhinitis J30.1 Allergic rhinitis due to pollen Allergy NOS due to pollen Hay fever Pollinosis

SJ30.2 Other seasonal allergic rhinitis

SJ30.5 Allergic rhinitis due to food

SJ30.8 Other allergic rhinitis

SJ30.81 Allergic rhinitis due to animal (cat) (dog) hair and dander

SJ30.89 Other allergic rhinitis

SPerennial allergic rhinitis

SJ30.9 Allergic rhinitis, unspecified

SJ31.0 Chronic rhinitis

SAtrophic rhinitis (chronic)

SGranulomatous rhinitis (chronic)

SHypertrophic rhinitis (chronic)

SObstructive rhinitis (chronic)


SPurulent rhinitis (chronic)

SRhinitis (chronic) NOS

SUlcerative rhinitis (chronic)

SExcludes1: allergic rhinitis (J30.1-J30.9)

Svasomotor rhinitis (J30.0)

Includes: Allergic (predominantly) asthma Allergic bronchitis NOS Allergic rhinitis with asthma Atopic asthma Extrinsic allergic asthma Hay fever with asthma 
Idiosyncratic asthma Intrinsic nonallergic asthma Nonallergic asthma

SExcludes 1:

Sdetergent asthma (J69.8)

Seosinophilic asthma (J82)

Slung diseases due to external agents (J60-J70)

SMiner’s asthma (J60)

Swheezing NOS (R06.2) wood asthma (J67.8)




Allergic Rhinitis - pollen


Allergic Rhinitis - danders


Allergic Rhinitis - other


Allergic Rhinitis - foods


Allergic Rhinitis - unspecified


Acute Atopic Conjunctivitis
H10.10- H10.13


Acute Conjunctivitis, unspecified eye

Acute conjunctiviitis, unspecified rt eye

Acute conjunctivitis, unspecified, left eye

Acute conjunctivitis, unspecified, bilateral


Acute Serous Conjunct-non viral
H10.231 thru H10.233


Chronic Allergic Conjunctivitis


Seasonal conjunctivitis-childhood

Simple chronic conjunctititis - right eye

Simple chronic conjunctivitis - left eye

Simple chronic conjunctivitis - bilateral

Simple chronic conjunctivitis - unspecified eye


OM acute allergic (mucoid) rt ear

OM allergic acute & subacute lt ear

OM allergic acute & subacute bilateral

OM allergic recurrent rt ear

OM allergic recurrent lt ear

OM allergic recurrent bilateral

OM allergic recurrent unspecified

OM allergic and subacute unspecified


OM Serous chronic, unspecified ear

OM serous chronic, right ear

OM Serous chronic, left ear

OM Serous chronic, bilateral


Skin Disorders



Atopic( neurodermatitis) Dermatitis

Perioral Dermatitis


Allergic eczema

Contact , allergic due to adhesives


Contact, allergic Dermatitis - animal


Contact, allergy due to cosmetics


Contact, allergy due to detergent


Contact, allergy due to drugs (topical)


Contact, allergy due to food


Contact, allergy due to latex, rubber


Contact, allergy due to metals

Contact, allergy Due to plants

Unspecified contact dermatitis, cosmetics

Unspecified contact dermatitis, drugs

Unspecified contact dermatitis, dyes

Unspec contact dermatitis -other chemicals (cement, insecticide)

Unspec contact dermatis food in contact

Unspecified contact dermatitis due to plants

For the practice of Allergy/Immunology, the conversion from ICD-9-CM to ICD-10-CM will be rather seamless for some diagnoses, and more complicated for others.

Asthma will be coded as intermittent or persistent, and add descriptors:

• Mild
• Moderate
• Severe

A fifth digit will be used to describe asthma as:
• Uncomplicated (x = 1)
• With exacerbation (x = 2)
• With status (x = 3).


# Not covered for Priority Health Medicaid Testing: (Laboratory tests are subject to laboratory benefits)
82785 Gammaglobulin; IgE

86001 Allergen specific IgG quantitative or semiquantitative, each allergen

86003 Allergen specific IgE; quantitative or semiquantitative, each allergen

86005 Allergen specific IgE; qualitative, multiallergen screen (dipstick, paddle or disk)

86021 Antibody identification; leukocyte antibodies

95004 Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction, including test interpretation and report by a physician, specify number of tests.

95012 Nitric oxide expired gas determination

95017 Allergy testing, any combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal), sequential and incremental, with venoms, immediate type reaction, including test interpretation and report, specify number of tests

95018 Allergy testing, any combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal), sequential and incremental, with drugs or biologicals, immediate type reaction, including test interpretation and report, specify number of tests

95024 Intracutaneous (intradermal) tests with allergenic extracts, immediate type reaction, including test interpretation and report by a physician, specify number of tests.

ICD-10 Codes that may support medical necessity:

D69.0 Allergic purpura
H10.401 – H10.409 Unspecified chronic conjunctivitis
H10.421 – H10.429 Simple chronic conjunctivitis
H10.44 Vernal conjunctivitis
H16.261 – H16.269 Vernal keratoconjunctivitis, with limbar and corneal involvement
H10.411 – H10.419 Chronic giant papillary conjunctivitis
H10.45 Other chronic allergic conjunctivitis
H10.9 Unspecified conjunctivitis
J30.0 – J30.9 Vasomotor and allergic rhinitis
J31.0 – J31.2 Chronic rhinitis, nasopharyngitis and pharyngitis
J32.0 – J32.9 Chronic sinusitis
J33.0 – J33.9 Nasal polyp
J45.20 – J45.998 Asthma
K52.21-K52.29 Allergic and dietetic gastroenteritis and colitis
K52.89 Other specified noninfective gastroenteritis and colitis
K52.9 Noninfective gastroenteritis and colitis, unspecified
L20.0 – L20.9 Atopic dermatitis
L22 Diaper dermatitis
L23.0 – L23.9 Allergic contact dermatitis
L24.0 – L24.9 Irritant contact dermatitis
L25.0 – L25.9 Unspecified contact dermatitis
L27.0 – L27.9 Dermatitis due to substances taken internally
L29.8 Other pruritus
L29.9 Pruritus, unspecified
L30.0 – L30.9 Other and unspecified dermatitis
L50.0 Allergic urticaria
L50.1 Idiopathic urticaria
L50.6 Contact urticaria
L50.8 Other urticaria
L50.9 Urticaria, unspecified
L56.4 Polymorphous light eruption
T50.905A-T50.905S Adverse effect of unspecified drugs, medicaments and biological substances
T50.995A-T50.905S Adverse effect of other drugs, medicaments and biological substances
T78.00xA-T78.1xxS Anaphylactic reaction due to food
T78.40xA-T78.49xS Other and unspecified allergy
Z01.82 Encounter for allergy testing
Z91.010 – Z91.09 Allergy status, other than to drugs and biological substances
Z88.0 Allergy status to penicillin
Z88.1 Allergy status to other antibiotic agents statusZ88.2 Allergy status to sulfonamides status
Z88.3 Allergy status to other anti-infective agents status
Z88.4 Allergy status to anesthetic agent status
Z88.5 Allergy status to narcotic agent status
Z88.6 Allergy status to analgesic agent status
Z88.7 Allergy status to serum and vaccine status
Z88.8 Allergy status to other drugs, medicaments and biological substances status
Z88.9 Allergy status to unspecified drugs, medicaments and biological substances status
Z91.010 Allergy to peanuts
Z91.011 Allergy to milk products
Z91.012 Allergy to eggs
Z91.013 Allergy to seafood
Z91.018 Allergy to other foods


K52.21 is a new, approved ICD-10 code for Food Protein-Induced Enterocolitis Syndrome FPIES is a non-IgE gastrointestinal food hypersensitivity that manifests as delayed, profuse vomiting, often with diarrhea, acute dehydration, and lethargy.

The most common triggers are milk and soy, but any food, even those thought to be hypoallergenic (e.g., rice and oat), can cause an FPIES reaction.

The new code is the result of advocacy efforts by the International Association for Food Protein Enterocolitis, a lay organization and partner of the AAAAI.


For the Respiratory disease, Chapter 10, the ICD-10 chapter instructions include the direction to use additional codes for describing the patient’s tobacco use, if documented in the patient’s medical record.

If the patient does not have a tobacco use, abuse, or dependence, no additional codes are required to describe your patient’s disease. For the patient who does use tobacco products and it is documented in their medical record, we must code not only their use but also describe the type of tobacco used.

The provider is directed to use only one code to describe the patient’s tobacco use. For example, if the patient uses and is dependent, you only assign the code for the dependence.

The provider must also select a sixth digit to describe if the patient’s dependence is as follows:

• 0 Uncomplicated
• 1 In remission
• 3 With withdrawal
• 8 With other nicotine-induced disorders
• 9 With unspecified nicotine-induced disorders


A patient presents with mild intermittent asthma who has smoked cigarettes in the past, but is not a current smoker. Your diagnosis codes would be J45.20 and Z87.891.

A patient presents with severe persistent asthma who is currently a long-time dependent cigarette smoker. Your diagnosis code would be J45.50 with F17.210.

A patient presents with moderate persistent asthma with no history of smoking or any use of tobacco products. Your correct diagnosis code(s) would be J45.40.


ICD-10 CM defines vasomotor rhinitis as a form of non-allergic rhinitis that is characterized by nasal congestion and posterior pharyngeal drainage.

J31.0 Chronic Rhinitis NOS description symptoms include:

• Rhinitis 
• Rhinitis (nasal congestion)
• Rhinitis (nasal congestion), chronic
• Rhinitis (nasal congestion), nonallergic
• Rhinitis due to alpha blocking medication
• Rhinitis due to alpha-adrenergic blocking agent
• Rhinitis medicamentosa

Allergy Sensitivity Testing:

These tests include the performance and evaluation of selective cutaneous and mucous membrane tests in correlation with history, physician examination, and other observations of the patient. The tests are performed to determine body sensitivity and reaction to the antigen for the purpose of diagnosing the presence of allergic reaction to antigenic stimuli. The number of tests performed should be judicious and dependent upon the history, physical findings and clinical judgment. All patients should not necessarily receive the same tests or the same number of sensitivity tests. Rather testing should be patient specific based on the history and physical examination.

These tests are injection of small amounts of antigen into the superficial layers of the skin. This is the preferred method for allergy testing. Medicare considers percutaneous (scratch, prick or puncture) testing medically reasonable and necessary when IgE-Medicated reactions occur to any of the following:

• Inhalants
• Foods
• Hymenoptera (stinging insects)
• Specific drugs (such as penicillin or macromolecular agents)

Allergy Testing

In order for allergy testing to be considered reasonable and necessary by Medicare, antigens must meet all the following criteria;• Skin testing must be performed based on history and physical exam,

• Proven efficacy as demonstrated through scientifically valid medical studies published in peer-review journal, and

• Exist in the patient's environment with a reasonable probability of exposure

Patch testing is the gold standard method of identifying the cause of allergic contact dermatitis. This testing is indicated to evaluate a nonspecific dermatitis, allergic contact dermatitis, pruritus, and other dermatitis to determine the causative antigen. It is a diagnostic test reserved for patients with skin eruptions for which a contact allergy source is likely.

Allergy patch testing is a covered procedure only when used to diagnose allergic contact dermatitis after the following exposures: dermatitis due to detergents, oils and greases, solvents, drugs and medicines in contact with skin, other chemical products, food in contact with skin, plants (except food), cosmetics, metals, other and unspecified.

Challenge ingestion food testing is a safe and effective technique in the diagnosis of food allergies. This procedure, when considered reasonable and necessary for the individual patient, is covered on an outpatient basis. Please refer to CMS Pub. 100-03, Medicare National Coverage Determination Manual, Chapter 1, Part 2 Section 110.12.

Medicare will consider challenge ingestion food testing reasonable and necessary for the following indications:

• Food allergy dermatitis
• Anaphylactic shock due to adverse food reaction
• Allergy to medicinal agents
• Allergy to foods

Challenge ingestion food testing has not been proven to be effective in the diagnosis of rheumatoid arthritis, depression, or respiratory disorders. Accordingly, its use in the diagnosis of these conditions is not reasonable and necessary within the meaning of Section 1862 (a)(1) of Medicare law. Therefore, this service is considered non-covered.

The number of tests done, choices of antigens, frequency of repetition and other coverage issues are the same as for skin testing. Control testing is essential for proper interpretation. It is rarely necessary to test for more than 50 allergens and, if food allergy is not suspected, fewer than 30 are usually sufficient. Testing must be based on a careful history/physical examination which suggests IgE- mediated disease. If testing is inconclusive, and contraindications have been resolved, then skin testing may be done and is considered reasonable and necessary. The medical records must document this rationale.

• Direct skin testing is not possible due to extensive dermatitis, dermographism, ichthyosis, generalized eczema or the necessary continued use of H-1 blockers (antihistamines), or in the rare patient with a persistent unexplained negative histamine control;

• Testing in patients who have been receiving long acting antihistamines, tricyclic antidepressants, betablockers or medication that may put the patient at undue risk if they are discontinued;

• Testing of uncooperative patients with mental or physical impairments;

• The evaluation of cross-reactivity between insect venoms;

• As adjunctive laboratory tests for disease activity of allergic bronchopulmonary aspergillosis and certain parasitic diseases; and

• When clinical history suggests an unusually greater risk of anaphylaxis from skin testing than usual (e.g., when an unusual allergen is not available as a licensed skin test extract).

• Total serum IgE: Measurements of total IgE levels (CPT code 82785-gammaglobulin {immunoglobulin}; IgE) are not appropriate in most general allergy testing which is performed to determine a patient’s immunologic sensitivity or reaction to particular allergens for the purpose of identifying the cause of the allergic state. It would not be expected that total serum IgE levels would be billed unless evidence exists for the following:

1. follow-up of bronchopulmonary aspergillosis,
2. to diagnose atopy in small children,
3. select immunodeficiency, such as the syndrome of hyper-IgE,
4. eczematous dermatitis,
5. recurrent pyogenic infections, or
6. in the evaluation of omalizumab therapy.

• Serial, repeat testing of total IgE will be subject to medical review. It is not appropriate in most general allergy testing. Instead, individual IgE tests are performed against a specific antigen.

Allergen-specific IgG and IgG subclasses measured by using immunoabsorption assays and IgG and IgG subclass antibody tests for food allergy/delayed food allergy /delayed food allergic symptoms or intolerance to specific foods (e.g. CPT code 86001) are considered experimental and investigational, as there is insufficient evidence in the published peer-reviewed scientific literature to support the diagnostic value of these tests for allergy testing.

No comments:

Medical Billing Popular Articles