2024 ICD-10-CM Diagnosis Code T80.52XS

Anaphylactic reaction due to vaccination, sequela

ICD-10-CM Code:
T80.52XS
ICD-10 Code for:
Anaphylactic reaction due to vaccination, sequela
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Not chronic
Code Navigator:

Code Classification

  • Injury, poisoning and certain other consequences of external causes
    (S00–T88)
    • Complications of surgical and medical care, not elsewhere classified
      (T80-T88)
      • Complications following infusion, transfusion and therapeutic injection
        (T80)

T80.52XS is a billable diagnosis code used to specify a medical diagnosis of anaphylactic reaction due to vaccination, sequela. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

T80.52XS is a sequela code, includes a 7th character and should be used for complications that arise as a direct result of a condition like anaphylactic reaction due to vaccination. According to ICD-10-CM Guidelines a "sequela" code should be used for chronic or residual conditions that are complications of an initial acute disease, illness or injury. The most common sequela is pain. Usually, two diagnosis codes are needed when reporting sequela. The first code describes the nature of the sequela while the second code describes the sequela or late effect.

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Adverse reaction to component of vaccine product containing Human alphaherpesvirus 3 antigen
  • Adverse reaction to component of vaccine product containing Human alphaherpesvirus 3 antigen
  • Adverse reaction to component of vaccine product containing Human alphaherpesvirus 3 antigen
  • Adverse reaction to component of vaccine product containing Human papillomavirus antigen
  • Adverse reaction to component of vaccine product containing low dose acellular Bordetella pertussis and Clostridium tetani and low dose Corynebacterium diphtheriae antigens
  • Adverse reaction to component of vaccine product containing only acellular Bordetella pertussis and Clostridium tetani and Corynebacterium diphtheriae antigens
  • Adverse reaction to component of vaccine product containing only live attenuated Human alphaherpesvirus 3 antigen
  • Adverse reaction to component of Vaccine product containing Rotavirus antigen
  • Adverse reaction to Haemophilus influenzae type b vaccine
  • Adverse reaction to hepatitis B vaccine
  • Anaphylactic reaction due to component of vaccine product
  • Anaphylaxis caused by component of vaccine product containing low dose acellular Bordetella pertussis and Clostridium tetani and low dose Corynebacterium diphtheriae antigens
  • Anaphylaxis caused by rotavirus vaccine
  • Anaphylaxis caused by vaccine containing Human alphaherpesvirus 3 antigen
  • Anaphylaxis caused by vaccine product containing Hepatitis A virus antigen
  • Anaphylaxis caused by vaccine product containing Hepatitis B virus antigen
  • Anaphylaxis caused by vaccine product containing human alphaherpesvirus 3 recombinant surface glycoprotein E antigen
  • Anaphylaxis caused by vaccine product containing Human papillomavirus antigen
  • Anaphylaxis caused by vaccine product containing human poliovirus antigen
  • Anaphylaxis caused by vaccine product containing Influenza virus antigen
  • Anaphylaxis caused by vaccine product containing live attenuated human alphaherpesvirus 3 antigen
  • Anaphylaxis caused by vaccine product containing Measles morbillivirus and Mumps orthorubulavirus and Rubella virus antigens
  • Anaphylaxis caused by vaccine product containing only Clostridium tetani and Corynebacterium diphtheriae antigens
  • Anaphylaxis caused by vaccine product containing only Haemophilus influenzae type b antigen
  • Anaphylaxis caused by vaccine product containing only Neisseria meningitidis antigen
  • Anaphylaxis caused by vaccine product containing Streptococcus pneumoniae antigen

Clinical Classification

Coding Guidelines

The appropriate 7th character is to be added to each code from block Complications following infusion, transfusion and therapeutic injection (T80). Use the following options for the aplicable episode of care:

  • A - initial encounter
  • D - subsequent encounter
  • S - sequela

Present on Admission (POA)

T80.52XS is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.

CMS POA Indicator Options and Definitions

POA IndicatorReason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert T80.52XS to ICD-9-CM

  • ICD-9-CM Code: 909.3 - Late eff surg/med compl
    Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Patient Education


Anaphylaxis

Anaphylaxis is a serious allergic reaction. It can begin very quickly, and symptoms may be life-threatening. The most common causes are reactions to foods (especially peanuts), medications, and stinging insects. Other causes include exercise and exposure to latex. Sometimes no cause can be found.

It can affect many organs:

  • Skin - itching, hives, redness, swelling
  • Nose - sneezing, stuffy nose, runny nose
  • Mouth - itching, swelling of the lips or tongue
  • Throat - itching, tightness, trouble swallowing, swelling of the back of the throat
  • Chest - shortness of breath, coughing, wheezing, chest pain or tightness
  • Heart - weak pulse, passing out, shock
  • Gastrointestinal tract - vomiting, diarrhea, cramps
  • Nervous system - dizziness or fainting

If someone is having a serious allergic reaction, call 911. If an auto-injector is available, give the person the injection right away.


[Learn More in MedlinePlus]

Vaccines

What are vaccines?

Vaccines are injections (shots), liquids, pills, or nasal sprays that you take to teach your body's immune system to recognize and defend against harmful germs. For example, there are vaccines to protect against diseases caused by:

  • Viruses, like the ones that cause the flu and COVID-19
  • Bacteria, including tetanus, diphtheria, and pertussis

What are the types of vaccines?

There are several types of vaccines:

  • Live-attenuated vaccines use a weakened form of the germ.
  • Inactivated vaccines use a killed version of the germ.
  • Subunit, recombinant, polysaccharide, and conjugate vaccines use only specific pieces of the germ, such as its protein, sugar, or casing.
  • Toxoid vaccines that use a toxin (harmful product) made by the germ.
  • mRNA vaccines use messenger RNA, which gives your cells instructions for how to make a protein (or piece of a protein) of the germ.
  • Viral vector vaccines use genetic material, which gives your cells instructions for making a protein of the germ. These vaccines also contain a different, harmless virus that helps get the genetic material into your cells.

Vaccines work in different ways, but they all spark an immune response. The immune response is the way your body defends itself against substances it sees as foreign or harmful. These substances include germs that can cause disease.

What happens in an immune response?

There are different steps in the immune response:

  • When a germ invades, your body sees it as foreign.
  • Your immune system helps your body fight off the germ.
  • Your immune system also remembers the germ. It will attack the germ if it ever invades again. This "memory" protects you against the disease that the germ causes. This type of protection is called immunity.

What are immunization and vaccination?

Immunization is the process of becoming protected against a disease. But it can also mean the same thing as vaccination, which is getting a vaccine to become protected against a disease.

Why are vaccines important?

Vaccines are important because they protect you against many diseases. These diseases can be very serious. So getting immunity from a vaccine is safer than getting immunity by being sick with the disease. And for a few vaccines, getting vaccinated can actually give you a better immune response than getting the disease would.

But vaccines don't just protect you. They also protect the people around you through community immunity.

What is community immunity?

Community immunity, or herd immunity, is the idea that vaccines can help keep communities healthy.

Normally, germs can travel quickly through a community and make a lot of people sick. If enough people get sick, it can lead to an outbreak. But when enough people are vaccinated against a certain disease, it's harder for that disease to spread to others. This type of protection means that the entire community is less likely to get the disease.

Community immunity is especially important for people who can't get certain vaccines. For example, they may not be able to get a vaccine because they have weakened immune systems. Others may be allergic to certain vaccine ingredients. And newborn babies are too young to get some vaccines. Community immunity can help to protect them all.

Are vaccines safe?

Vaccines are safe. They must go through extensive safety testing and evaluation before they are approved in the United States.

What is a vaccine schedule?

A vaccine, or immunization, schedule lists which vaccines are recommended for different groups of people. It includes who should get the vaccines, how many doses they need, and when they should get them. In the United States, the Centers for Disease Control and Prevention (CDC) publishes the vaccine schedule.

It's important for both children and adults to get their vaccines according to the schedule. Following the schedule allows them to get protection from the diseases at exactly the right time.


[Learn More in MedlinePlus]

Vaccine Safety

What are vaccines?

Vaccines play an important role in keeping us healthy. They protect us from serious and sometimes deadly diseases. Vaccines are injections (shots), liquids, pills, or nasal sprays that you take to teach your body's immune system to recognize and defend against harmful germs. The germs could be viruses or bacteria.

Some types of vaccines contain germs that cause disease. But the germs have been killed or weakened enough that they won't make you sick. Some vaccines only contain a part of a germ. Other types of vaccines include instructions for your cells to make a protein of the germ.

These different vaccine types all spark an immune response, which helps your body fight off the germs. Your immune system will also remember the germ and attack it if that germ ever invades again. This protection against a certain disease is called immunity.

These diseases can be very serious. Because of this, getting immunity from a vaccine is safer than getting immunity by being sick with the disease. And for a few vaccines, getting vaccinated can actually give you a better immune response than getting the disease would.

Do vaccines cause side effects?

As with medicines, any vaccine can cause side effects. Most of the time the side effects are minor, such as a sore arm, fatigue, or mild fever. They usually go away within a few days. These common side effects are often a sign that your body is starting to build immunity against a disease.

Serious side effects from vaccines can happen, but they are very rare. These side effects could include a severe allergic reaction. Other possible side effects are different for each vaccine. Talk with your health care provider if you're concerned about your health after getting vaccinated.

Some people worry that childhood vaccines could cause autism spectrum disorder (ASD). But many scientific studies have looked at this and have found no link between vaccines and ASD.

How are vaccines tested for safety?

Every vaccine that is approved in the United States goes through extensive safety testing. It starts with testing and evaluation of the vaccine before it's approved by the Food and Drug Administration (FDA). This process can often take several years.:

  • First, the vaccine is tested in labs. Based on those tests, the FDA decides whether to test the vaccine with people.
  • Testing with people is done through clinical trials. In these trials, the vaccines are tested on volunteers. Clinical trials usually start with 20 to 100 volunteers, but eventually include thousands of volunteers.
  • The clinical trials have three phases. The trials are looking for the answer to important questions such as
    • Is the vaccine safe?
    • What dose (amount) works best?
    • How does the immune system react to it?
    • How effective is it?
  • During the process, the FDA works closely with the company who makes the vaccine to evaluate the vaccine's safety and effectiveness. If the vaccine is found to be safe and effective, it will be approved and licensed by the FDA.
  • After a vaccine is licensed, experts may consider adding it to the recommended vaccine, or immunization, schedule. This schedule is from the Centers for Disease Control and Prevention (CDC). It lists which vaccines are recommended for different groups of people. They list which age groups should get which vaccines, how many doses they need, and when they should get them.

Testing and monitoring continue after the vaccine is approved:

  • The company making the vaccines tests every batch of vaccines for quality and safety. The FDA reviews the results of these tests. It also inspects the factories where the vaccine is made. These checks help make sure the vaccines meet standards for quality and safety.
  • The FDA, CDC, and other federal agencies continue to monitor its safety, to watch for possible side effects. They have systems to track any safety issues with the vaccines.

These high safety standards and testing help to make sure that vaccines in the United States are safe. Vaccines help protect against serious, even deadly, diseases. They not only protect you, but also help to keep these diseases from spreading to others.


[Learn More in MedlinePlus]

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.