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T78.01 vs T78.05XA

T78.01 (Anaphylactic reaction due to peanuts) compared with T78.05XA (Anaphylactic reaction due to tree nuts and seeds, initial encounter), from the official CMS tabular data.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Summary

These codes can be reported together when both conditions are documented, because T78.05XA lists T78.01 under Excludes2, which marks them as distinct conditions.

Official rule
What is different?

Title wording and billing status.The titles share “Anaphylactic reaction due to”; T78.01 says “peanuts” where T78.05XA says “tree nuts and seeds, initial encounter”. T78.01 is a non-billable header; T78.05XA is billable.

Registry fact

Can these codes be reported together?

Yes, when both are documented.T78.05XA lists T78.01 under Excludes2: “anaphylactic reaction due to peanuts (T78.01)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes2 relationship?

Yes.T78.05XA’s tabular entry: “anaphylactic reaction due to peanuts (T78.01)”. The note covers T78.01.

Official ruleGuide: Excludes1 vs Excludes2

Is one a parent or header code?

One is a header.T78.01 is a non-billable header, but T78.05XA is not one of its subdivisions.

Registry fact

Nothing found in 4 other checks
Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code.

Official rule

Is one more specific?

No.Neither is a subdivision of the other, and neither title is the unspecified form; they describe different conditions within category T78.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Informational

Excludes2 relationship

T78.05XA
Anaphylactic reaction due to tree nuts and seeds, initial encounter
↔
T78.01
Anaphylactic reaction due to peanuts

What we found

Yes, when both are documented.T78.05XA carries an Excludes2 note covering T78.01: “anaphylactic reaction due to peanuts (T78.01)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

What to review

Report both only when the documentation supports both conditions; otherwise report the one documented.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source / rule

CMS ICD-10-CM tabular instructional notes

Official guidance behind these answers

  • Section I.A.12.b — Excludes2 · applies to: Excludes2

    A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.

    ICD-10-CM Official Guidelines FY2027

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

Similar descriptions do not make codes interchangeable. The documentation and the official instructions decide which code applies.

Official descriptionDiffers
T78.01

Anaphylactic reaction due to peanuts

T78.05XA

Anaphylactic reaction due to tree nuts and seeds, initial encounter

StatusDiffers
T78.01
Non-billable header

A header is not reported on a claim; a code beneath it is.

Report instead: T78.01XA, T78.01XD, T78.01XS

T78.05XA
Billable
Excludes2Differs
Only at T78.01

No note of its own beyond the shared notes

Only at T78.05XA
  • anaphylactic reaction due to peanuts (T78.01)
Shared by both codes (1 note)
  • complications of surgical and medical care NEC (T80-T88)
Code alsoSame for both
  • , if applicable, place of occurrence, such as:
  • highway rest stop (Y92.523)
  • school (private) (public) (state) as the place of occurrence of the external cause (Y92.21-)
  • service areas as the place of occurrence of the external cause (Y92.52-)
  • single-family non-institutional (private) house as the place of occurrence of the external cause (Y92.01-)
  • transport vehicle as the place of occurrence of the external cause (Y92.81-)
CategorySame for both

T78 Adverse effects, not elsewhere classified

ChapterSame for both

S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)

7th characterSame for both
  • The appropriate 7th character is to be added to each code from category T78

No Excludes1, Code first, Use additional code and Includes note at either code.

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on. In a row that differs, each code’s own notes are listed under it, and the notes every code shares are listed once beneath them.

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Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources