ICD-10 Guide

R76.12

Nonspecific reaction to cell mediated immunity measurement of gamma interferon antigen response without active tuberculosis

BILLABLE STATUSYes

IMPLEMENTATION DATEOctober 1, 2015

LAST UPDATED09/11/2025

Code Description

ICD-10 R76.12 is a billable code used to indicate a diagnosis of nonspecific reaction to cell mediated immunity measurement of gamma interferon antigen response without active tuberculosis.

Key Diagnostic Point:

R76.12 is used to classify a nonspecific reaction observed in patients undergoing cell-mediated immunity testing, specifically the gamma interferon release assay (IGRA), which is utilized to assess the immune response to specific tuberculosis antigens. This code indicates that while the test has shown a reaction, there is no evidence of active tuberculosis disease. Symptoms may include fatigue, malaise, or other nonspecific systemic symptoms, but these are not directly attributable to tuberculosis. The nonspecific nature of the reaction can arise from prior exposure to non-tuberculous mycobacteria, vaccination with the Bacillus Calmette-Guérin (BCG) vaccine, or other immune responses. Clinicians must interpret these results in conjunction with clinical findings and risk factors for tuberculosis exposure. The absence of active disease is crucial for accurate diagnosis and management, as it influences treatment decisions and public health reporting.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

Interpretation of test results can vary based on patient history.
Differentiating between active tuberculosis and latent infection.
Potential for overlapping symptoms with other conditions.
Need for comprehensive documentation to support coding.

Audit Risk Factors

Inadequate documentation of test results and clinical correlation.
Misinterpretation of nonspecific reactions leading to incorrect coding.
Failure to document the absence of active tuberculosis.
Inconsistent use of the code across different providers.

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed patient history, test results, and clinical correlation must be documented.

Common Clinical Scenarios

Patients presenting with respiratory symptoms and a positive IGRA test but no active TB.

Billing Considerations

Consideration of prior TB exposure and vaccination history is essential.

Emergency Medicine

Documentation Requirements

Acute care documentation must include the reason for testing and any immediate clinical findings.

Common Clinical Scenarios

Patients presenting with acute respiratory distress and a history of TB exposure.

Billing Considerations

Rapid assessment of symptoms and history is critical for accurate coding.

Coding Guidelines

Inclusion Criteria

Use R76.12 When

Follow official ICD
CM coding guidelines, ensuring that the code is supported by clinical documentation and that the absence of active tuberculosis is clearly stated

Exclusion Criteria

Do NOT use R76.12 When

No specific exclusions found.

Related CPT Codes

86480CPT Code

Interferon gamma release assays (IGRA) for tuberculosis

Clinical Scenario

Used for screening patients at risk for tuberculosis.

Documentation Requirements

Document the reason for the test and any relevant patient history.

Specialty Considerations

Internal medicine and infectious disease specialists frequently order this test.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of nonspecific reactions to immune responses, improving the granularity of data for public health reporting and clinical management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of nonspecific reactions to immune responses, improving the granularity of data for public health reporting and clinical management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of nonspecific reactions to immune responses, improving the granularity of data for public health reporting and clinical management.

Resources

Clinical References

•
ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

•
ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What does a positive IGRA test mean?

A positive IGRA test indicates that the patient has been exposed to tuberculosis antigens, but it does not confirm active tuberculosis disease. Further evaluation is necessary.

How should I document a nonspecific reaction?

Document the patient's history, the reason for the test, the test results, and any clinical findings that support the diagnosis of R76.12.

ICD-10 R76.12 is a billable code used to indicate a diagnosis of nonspecific reaction to cell mediated immunity measurement of gamma interferon antigen response without active tuberculosis.