2025 ICD-10-CM code R76.12
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Symptoms, signs and abnormal clinical and laboratory findings - Abnormal findings on examination of blood, without diagnosis Chapter 18: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) Feed
Nonspecific reaction to a cell-mediated immunity measurement (e.g., interferon-gamma release assay) for tuberculosis, without active tuberculosis.
Medical necessity for an IGRA is typically established based on risk factors for tuberculosis exposure (e.g., close contact with a confirmed case, recent travel to high-prevalence areas, immunosuppression) or as part of routine screening for specific occupational groups. In this case, a nonspecific result without further clinical findings of active disease could potentially negate the medical necessity for further investigation.
The clinical responsibility lies with the physician or healthcare professional who orders and interprets the interferon-gamma release assay (IGRA) and assesses the patient for signs and symptoms of active tuberculosis.This includes considering the patient's risk factors, medical history, and clinical presentation to determine the significance of the nonspecific result.
- Chapter 18: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
- R76.12 is within the block of codes R76.-, which represents nonspecific reactions to various immune system tests.
In simple words: This code is for when a blood test for tuberculosis shows an abnormal result, but you don't actually have active tuberculosis.The test shows your body reacted to the TB, but it doesn't mean you're sick with the disease.
This code is used to classify a nonspecific reaction to a test measuring cell-mediated immunity in response to tuberculosis antigens (such as an interferon-gamma release assay, or IGRA).The reaction is considered nonspecific because it doesn't definitively indicate active tuberculosis infection.It signifies an immune response detected by the test but without clinical or radiological evidence of active TB disease. This code is distinct from a positive tuberculin skin test (TST) result, which is coded differently.The absence of active TB is crucial for using this code.
Example 1: A patient with a history of close contact with an individual diagnosed with active tuberculosis undergoes an IGRA. The test result shows a nonspecific reaction, without any clinical symptoms or radiological findings suggesting active tuberculosis infection.R76.12 is assigned., A healthcare worker who had previous exposure to tuberculosis undergoes routine screening using an IGRA test. The test returns a nonspecific reaction; however, a chest x-ray and physical examination are unremarkable for active disease. The physician assigns R76.12., An asymptomatic patient undergoes an IGRA as part of a pre-employment health screening.The result indicates a nonspecific reaction. The patient has no other symptoms, and further investigations (chest x-ray) rule out active disease.R76.12 is appropriately coded.
Documentation should include details of the IGRA test performed (e.g., type of assay, manufacturer, date of test), results of the test (specifically indicating a nonspecific reaction), and the clinical assessment of the patient including a complete review of systems, physical examination findings, and results of any further investigations (e.g., chest x-ray) to rule out active tuberculosis.A statement explicitly indicating the absence of active TB is crucial for coding accuracy.
** This code is specifically for nonspecific reactions to interferon-gamma release assays (IGRAs) and should not be used for other types of TB tests such as the tuberculin skin test (TST).R76.12 is a significant code for tracking and monitoring latent TB infection in at-risk populations and healthcare workers.
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- Specialties:Pulmonology, Infectious Diseases
- Place of Service:Office, Outpatient Hospital, Clinic