2025 ICD-10-CM code R76.1

Nonspecific reaction to a test for tuberculosis.

Follow current ICD-10-CM coding guidelines and official coding conventions. Use the most specific code available based on the test results and clinical findings. If other abnormal immunological findings exist, additional codes may be necessary.

Not applicable to ICD-10 codes.

Medical necessity for this code would be established by the need to screen for latent tuberculosis infection (LTBI) or evaluate an abnormal reaction to a previous tuberculosis test.This could be based on risk factors such as close contact with an individual with active tuberculosis, immigration from high-prevalence areas, or other conditions that increase susceptibility to tuberculosis.

The clinical responsibility lies with the physician who orders and interprets the tuberculosis test.This includes obtaining a complete patient history, performing a physical examination if necessary, ordering and interpreting the results, and counseling the patient about the implications of the test results.

IMPORTANT R76.11 (Nonspecific reaction to tuberculin skin test without active tuberculosis), R76.12 (Nonspecific reaction to cell-mediated immunity measurement of gamma interferon antigen response without active tuberculosis) may be more specific depending on the type of test performed.

In simple words: The test for tuberculosis showed an abnormal result, but it doesn't mean you have active TB.It might mean you've been exposed to TB in the past or had a reaction for another reason.More tests might be needed.

This code signifies a nonspecific reaction to a tuberculosis test, such as a tuberculin skin test or an interferon-gamma release assay (IGRA).The reaction is not indicative of active tuberculosis but rather suggests prior exposure or a non-specific immune response.Further investigation may be necessary to determine the cause of the reaction.

Example 1: A patient presents for a routine physical examination.A tuberculin skin test is performed as part of the assessment.The test shows an induration of 10mm, considered a nonspecific reaction.No other symptoms or signs of tuberculosis are present.R76.1 is coded., A healthcare worker undergoes a routine screening test for tuberculosis using an IGRA assay. The results indicate an abnormal response, although the individual is asymptomatic and has no other indication of active disease. R76.1 is coded., A patient with a history of BCG vaccination has a tuberculin skin test. A positive reaction is obtained. However, a chest x-ray and clinical evaluation do not reveal any evidence of active TB.R76.1 is coded.

Documentation should include the type of tuberculosis test performed (e.g., tuberculin skin test, IGRA), the test result, the date the test was performed, relevant patient history, physical examination findings, and a clinical assessment ruling out active tuberculosis.

** This code should only be used when the reaction to the tuberculosis test is nonspecific and there is no clinical evidence of active tuberculosis.If active tuberculosis is present, the appropriate code for active tuberculosis should be used instead.The use of R76.1 may be impacted by additional findings or patient conditions. Consult medical resources and coding manuals for further clarification.Always ensure coding is compliant with payer guidelines.

  • Revenue Code: Revenue codes will vary depending on the type of service provided (e.g., physician visit, laboratory test).Appropriate revenue codes should be selected based on the specific services performed and payer requirements.
  • RVU: RVUs are not directly associated with ICD-10 codes. RVUs are associated with CPT codes and vary depending on the place of service, geographic location, and payer. Consult a relevant RVU database for applicable values.
  • Global Days : Not applicable. This is a diagnostic code, not a procedural code.
  • Payment Status: Active
  • Modifier TC rule: Not applicable to ICD-10 codes.
  • Fee Schedule : Not applicable to ICD-10 codes.
  • Specialties:Pulmonology, Infectious Disease, Internal Medicine, Family Medicine
  • Place of Service:Office, Clinic, Hospital (Inpatient or Outpatient), Other appropriate locations where tuberculosis testing is performed
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