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L23 vs T78.41XD

L23 (Allergic contact dermatitis) compared with T78.41XD (Arthus phenomenon, subsequent encounter), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Can these codes be reported together?

No — do not report together. T78.41XD carries an Excludes1 note covering L23: “dermatitis (L23-L25, L27.-)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Side by side

L23Allergic contact dermatitisT78.41XDArthus phenomenon, subsequent encounter
Billing statusNon-billable header

Report instead: L23.0, L23.1, L23.2, L23.3, L23.4

Billable
ClassificationL00-L99 — Diseases of the Skin and Subcutaneous Tissue (L00-L99)S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)
DefinitionAllergic contact dermatitis is a non-billable ICD-10-CM category code (L23).Arthus phenomenon, subsequent encounter is a billable ICD-10-CM diagnosis code (T78.41D).
7th characterThe appropriate 7th character is to be added to each code from category T78
Includes
Arthus reaction

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources