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Allergic Rhinitis F004

Last amended 
25 June 2015
Current RMA Instruments:
Reasonable Hypothesis
22 of 2014
Balance of Probabilities
23 of 2014
Changes from Previous Instruments:

SOP Bulletin 173

ICD Coding:
  • ICD-9-CM Codes: 477.0, 477.8, 477.9
  • ICD-10-AM Codes: J30.1, J30.2, J30.3, J30.4

This is a condition of the nasal passages which is due to atopic (allergic) predisposition. Also known as Hay fever. Consideration should be given to whether the liability is being determined for the disease episode (only) or for the disease itself.

Is specific diagnostic evidence required to apply the SOP?No.

The relevant medical specialist is an ENT surgeon or an immunologist.

Are there sub-factors that require specific information? – Yes.

Note that the allergenic stimulus factor requires skin prick testing, RAST or provocation/ challenge testing.

Additional diagnoses covered by SOP
  • Hay fever
Conditions excluded from SOP
  • Non-allergic rhinitis or sinusitis.
Unconfirmed diagnosis

If, after applying the above information, you are unable to confirm the diagnosis, you should then seek medical officer advice about further investigation.


Rhinitis classification:
  • Allergic rhinitis – current SOP
  • Chronic Rhino-sinusitis - See Sinusitis SOP
  • Rhinitis associated with structural nasal problems such as adenoids, foreign bodies, septal deviation or septal perforation, nasal polyps, nasal tumours.
  • Rhinitis as a manifestation of systemic diseases – Wegener’s granulomatosis, cystic fibrosis, hypothyroidism, immotile cilia syndromes.
  • Rhinitis in pregnancy - NON-SOP.
  • Rhinitis medicamentosa - NON-SOP
  • Non-allergic or vasomotor rhinitis (ICD-9 477.9; ICD-10 J30.0) à NON-SOP
  • Atrophic rhinitis - NON-SOP