2025 ICD-10-CM code J30.1
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the respiratory system - Vasomotor and allergic rhinitis Chapter 10: Diseases of the respiratory system Feed
Allergic rhinitis specifically caused by pollen.
Medical necessity for coding J30.1 is established by the presence of symptoms consistent with allergic rhinitis caused by pollen.This may be supported by a thorough history and physical examination, and possibly allergy testing.The severity of the symptoms, impact on daily activities, and the need for medical intervention (e.g., medication, allergy shots) also contributes to the medical necessity determination.
The clinical responsibility for this diagnosis lies with the physician or healthcare provider who performs the evaluation and diagnosis of the patient's allergic rhinitis, potentially including allergy testing to confirm the pollen allergy.Management may involve medication prescriptions (e.g., antihistamines, nasal corticosteroids), allergy immunotherapy (allergy shots), and patient education on avoidance strategies.
In simple words: This code means you have a stuffy or runny nose, sneezing, and itchy eyes, nose, and throat because of an allergy to pollen (tiny particles released by plants like trees and grasses). It usually happens during certain times of the year when specific plants are releasing pollen.
J30.1, Allergic rhinitis due to pollen, is an ICD-10-CM code that classifies allergic rhinitis (inflammation of the nasal mucous membranes) triggered by pollen.This code is used when the allergen causing the rhinitis is definitively identified as pollen from plants such as grasses, trees, or weeds. The condition is characterized by symptoms like sneezing, runny or stuffy nose, itchy eyes, nose, and throat, and sometimes coughing and postnasal drip.It's a seasonal condition, typically occurring during spring, summer, and early fall, coinciding with the pollen seasons of different plants.
Example 1: A 25-year-old female patient presents with symptoms of sneezing, nasal congestion, and itchy eyes during the spring.Allergy testing confirms a pollen allergy (specifically tree pollen).J30.1 is the appropriate code., A 10-year-old male patient experiences seasonal allergic rhinitis every summer, with symptoms worsening during peak grass pollen season.Physical examination and history confirm the diagnosis.J30.1 is the correct code., An adult patient presents with year-round allergic rhinitis. While pollen may be a contributing factor, other allergens are also likely involved. In this case, J30.89 (Other allergic rhinitis) or J30.9 (Allergic rhinitis, unspecified) might be more appropriate than J30.1, unless specific testing identifies pollen as the primary allergen.
Documentation should include a detailed patient history, including symptoms (sneezing, runny or stuffy nose, itchy eyes, nose, throat), duration of symptoms, seasonal correlation (if applicable), allergy testing results (if performed), and the specific type of pollen causing the reaction (if known).The provider's assessment and diagnosis should be clearly documented.
** The use of J30.1 requires clear documentation specifying that the allergic rhinitis is due to pollen.If the allergen is unknown or multiple allergens are involved, other codes within the J30 range should be considered.
- Payment Status: Active
- Specialties:Allergists/Immunologists, Family Medicine, Pediatrics, Otolaryngology
- Place of Service:Office, Outpatient clinic, Hospital outpatient department, Emergency Room