Coding and coverage · ICD-10-CM

T78 › T78.4 › T78.40

T78.40XA Allergy, unspecified, initial encounter

BillableNo payment HCCChapter 19

7th character A: initial encounter

Instructional notes

Chapter 19

Excludes2Not included here: the patient may have both; report both when both are present.
Use additional codeAdd a second code for the full picture.
  • code to identify any retained foreign body, if applicable (Z18.-)
Notes
  • Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
  • The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.

T78

Excludes2Not included here: the patient may have both; report both when both are present.
  • complications of surgical and medical care NEC (T80-T88)
7th charactersThe appropriate 7th character is to be added to each code from category T78
  • A initial encounter
  • D subsequent encounter
  • S sequela

T78.4

Excludes1Not coded here: never report with this code, except when the two conditions are unrelated.
  • specified types of allergic reaction such as:
  • allergic diarrhea (K52.29)
  • allergic gastroenteritis and colitis (K52.29)
  • dermatitis (L23-L25, L27.-)
  • food protein-induced enterocolitis syndrome (K52.21)
  • food protein-induced enteropathy (K52.22)
  • hay fever (J30.1)

T78.40

Inclusion terms
  • Allergic reaction NOS
  • Hypersensitivity NOS

Chapter 19: Injury, poisoning and certain other consequences of external causes · T07-T88 Injury, poisoning and certain other consequences of external causes (T07-T88)

Source: ICD-10-CM FY 2027 code descriptions and tabular list (CMS and CDC National Center for Health Statistics), effective 2026-10-01 through 2027-09-30 · CMS ICD-10 files. HCC mapping: CMS-HCC V28, payment year 2027. As of 2026-11-04.

Coverage and payment depend on the claim details; confirm with the Medicare Administrative Contractor.