Allergic rhinoconjunctivitis ICD-9 coding

Good afternoon,

I have noticed in both adult and pediatric practices where it is documented that a patient has "allergic rhinitis with allergic conjunctivitis". There is no mention in the note as to whether these conditions are acute or chronic. Furthermore, there is no mention of a specific allergen.

I cannot find a Coding Clinic on this subject, aside from the one on giant papillary conjunctivitis, which does not apply to this situation. I cannot locate any information regarding this diagnostic statement in the Official Coding Guidelines, nor does the ICD-9-CM manual provide much guidance on the matter (no inlcudes or excludes notes).

The account I'm looking at right now is a pediatric account. I have indexed "allergy -> rhinitis" which yields 477.9. Additionally, I have indexed "allergy -> conjunctivitis" which yields 372.14. I've also looked at "conjunctivitis -> allergic (chronic) -> with hay fever" which takes me to 372.05.

So...my questions are:

1) Should I use both 477.9 and 372.14 to fully capture this diagnostic statement? If so, which should go in as the first-listed diagnosis? I'm leaning toward 477.9.

2) If not, is there a combination code that I'm not aware of? If this is the case, what is that ICD-9 code? Again, I'm looking at 372.05 since it covers both the allergic conjunctivitis and hay fever.

Thanks,
Cynthia G. Jackson Phyfer, RHIA, CCS-P