Allergic Rhinitis F004

Current RMA Instruments
Reasonable Hypothesis
111 of 2022
Balance of Probabilities
112 of 2022
Changes from previous Instruments

ICD Coding

ICD-10-AM Codes: J30.1, J30.2, J30.3, J30.4

Brief description

This is inflammation of the lining of the nose caused by allergy.  It is also known as hay fever.  It may occur in conjunction with sinusitis, which is covered by a separate SOP. 

Confirming the diagnosis

The diagnosis is made on clinical grounds and is usually made by a general practitioner.  No specific investigation or imaging is required.

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

Additional diagnoses covered by SOP
  • Hay fever
Conditions excluded from SOP
  • Irritant rhinitis#
  • Non-allergic rhinitis#
  • Sinusitis*
  • Vasomotor rhinitis#

* Another SOP applies

# Non-SOP condition

Clinical onset

Common symptoms are sneezing, a running and/or blocked nose, and nasal itching.  Postnasal drip and cough may also be present.

The condition may be seasonal/intermittent or perennial/persistent.  If the condition is episodic (e.g. seasonal) then each new episode does not represent a new clinical onset, but rather a recurrence of the condition.  Clinical onset will be when the condition first presented.

Clinical worsening

Clinical worsening may be evidenced by a persistent increase in the severity, duration or frequency of symptoms.

 

 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/b/allergic-rhinitis-f004-j301j302j303j304

Last amended

Rulebase for allergic rhinitis

<h5>Current RMA Instruments</h5><table border="1" cellpadding="1" cellspacing="1"><tbody><tr><td><address><a href="http://www.rma.gov.au/assets/SOP/2022/1e463a8aeb/111.pdf&quot; target="_blank">Reasonable Hypothesis</a></address></td><td>111 of 2022</td></tr><tr><td><address><a href="http://www.rma.gov.au/assets/SOP/2022/ead3079296/112.pdf&quot; target="_blank">Balance of Probabilities</a></address></td><td>112 of 2022</td></tr></tbody></table><h5>Changes from previous Instruments</h5><p><drupal-media data-entity-type="media" data-entity-uuid="ddf2ba15-af0f-4c1b-8774-df37316c981f" data-view-mode="wysiwyg"></drupal-media></p><h5>ICD Coding</h5><p>ICD-10-AM Codes: J30.1, J30.2, J30.3, J30.4</p><h5>Brief description</h5><p>This is inflammation of the lining of the nose caused by allergy.  It is also known as hay fever.  It may occur in conjunction with sinusitis, which is covered by a separate SOP. </p><h5>Confirming the diagnosis</h5><p>The diagnosis is made on clinical grounds and is usually made by a general practitioner.  No specific investigation or imaging is required.</p><p>The relevant medical specialist is an ENT surgeon or an immunologist.</p><h5><b>Additional diagnoses covered by SOP</b></h5><ul><li>Hay fever</li></ul><h5><b>Conditions excluded from SOP </b></h5><ul><li>Irritant rhinitis<span lang="EN" xml:lang="EN"><sup>#</sup></span></li><li>Non-allergic rhinitis<span lang="EN" xml:lang="EN"><sup>#</sup></span></li><li>Sinusitis*</li><li>Vasomotor rhinitis<span lang="EN" xml:lang="EN"><sup>#</sup></span></li></ul><p>* Another SOP applies</p><p><sup><span lang="EN" xml:lang="EN">#</span></sup> Non-SOP condition</p><h5>Clinical onset</h5><p>Common symptoms are sneezing, a running and/or blocked nose, and nasal itching.  Postnasal drip and cough may also be present.</p><p>The condition may be seasonal/intermittent or perennial/persistent.  If the condition is episodic (e.g. seasonal) then each new episode does not represent a new clinical onset, but rather a recurrence of the condition.  Clinical onset will be when the condition first presented.</p><h5>Clinical worsening</h5><p>Clinical worsening may be evidenced by a persistent increase in the severity, duration or frequency of symptoms.</p><p> </p><p> </p>

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/b/allergic-rhinitis-f004-j301j302j303j304/rulebase-allergic-rhinitis

Exposure to allergen causing allergic rhinitis

Current RMA Instruments
Reasonable Hypothesis
111 of 2022
Balance of Probabilities
112 of 2022
Changes from previous Instruments

ICD Coding

ICD-10-AM Codes: J30.1, J30.2, J30.3, J30.4

Brief description

This is inflammation of the lining of the nose caused by allergy.  It is also known as hay fever.  It may occur in conjunction with sinusitis, which is covered by a separate SOP. 

Confirming the diagnosis

The diagnosis is made on clinical grounds and is usually made by a general practitioner.  No specific investigation or imaging is required.

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

Additional diagnoses covered by SOP
  • Hay fever
Conditions excluded from SOP
  • Irritant rhinitis#
  • Non-allergic rhinitis#
  • Sinusitis*
  • Vasomotor rhinitis#

* Another SOP applies

# Non-SOP condition

Clinical onset

Common symptoms are sneezing, a running and/or blocked nose, and nasal itching.  Postnasal drip and cough may also be present.

The condition may be seasonal/intermittent or perennial/persistent.  If the condition is episodic (e.g. seasonal) then each new episode does not represent a new clinical onset, but rather a recurrence of the condition.  Clinical onset will be when the condition first presented.

Clinical worsening

Clinical worsening may be evidenced by a persistent increase in the severity, duration or frequency of symptoms.

 

 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/b/allergic-rhinitis-f004-j301j302j303j304/rulebase-allergic-rhinitis/exposure-allergen-causing-allergic-rhinitis

Inability to obtain appropriate clinical management for allergic rhinitis

Current RMA Instruments
Reasonable Hypothesis
111 of 2022
Balance of Probabilities
112 of 2022
Changes from previous Instruments

ICD Coding

ICD-10-AM Codes: J30.1, J30.2, J30.3, J30.4

Brief description

This is inflammation of the lining of the nose caused by allergy.  It is also known as hay fever.  It may occur in conjunction with sinusitis, which is covered by a separate SOP. 

Confirming the diagnosis

The diagnosis is made on clinical grounds and is usually made by a general practitioner.  No specific investigation or imaging is required.

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

Additional diagnoses covered by SOP
  • Hay fever
Conditions excluded from SOP
  • Irritant rhinitis#
  • Non-allergic rhinitis#
  • Sinusitis*
  • Vasomotor rhinitis#

* Another SOP applies

# Non-SOP condition

Clinical onset

Common symptoms are sneezing, a running and/or blocked nose, and nasal itching.  Postnasal drip and cough may also be present.

The condition may be seasonal/intermittent or perennial/persistent.  If the condition is episodic (e.g. seasonal) then each new episode does not represent a new clinical onset, but rather a recurrence of the condition.  Clinical onset will be when the condition first presented.

Clinical worsening

Clinical worsening may be evidenced by a persistent increase in the severity, duration or frequency of symptoms.

 

 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/b/allergic-rhinitis-f004-j301j302j303j304/rulebase-allergic-rhinitis/inability-obtain-appropriate-clinical-management-allergic-rhinitis