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Home/Diagnosis/ICD-10 Coding for Adverse Reaction to Medication

ICD-10 Coding for Adverse Reaction to Medication

T36.0X5A
T88.6

Complete ICD-10-CM coding and documentation guide for icd-10 coding for adverse reaction to medication includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Drug Reaction
Medication Side Effect
Adverse Drug Event
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Key Information: ICD-10 Coding for Adverse Reaction to Medication

Essential facts and insights about ICD-10 Coding for Adverse Reaction to Medication

Use ICD-10 code T36.0X5A for adverse effect of penicillins, initial encounter, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Adverse effect of penicillins, initial encounter

Billable Code
T36.0X5A
Billable

Diagnostic Criteria

clinical:
  • • Patient exhibits symptoms consistent with an adverse drug reaction post-administration.
documentation:
  • • Clear documentation of drug administration and subsequent reaction.

Applicable To

  • • Adverse effect of penicillin

Important Notes

  • • Ensure documentation specifies the drug was administered correctly.

Anaphylactic shock due to adverse effect of correct drug or medicament properly administered

Non-Billable
T88.6
Non-Billable

Diagnostic Criteria

clinical:
  • • Clinical documentation of anaphylactic symptoms post-drug administration

Applicable To

  • • Anaphylactic shock due to drug

Important Notes

  • • Ensure anaphylaxis is clearly documented with symptoms and timing.
Ancillary Codes

Additional codes that may be used with this diagnosis

R21

Rash and other nonspecific skin eruption

Use to describe skin manifestations of the adverse reaction.

R60.0

Localized edema

Use to describe swelling associated with anaphylaxis.

Frequently Asked Questions

What is the ICD-10 code for an adverse reaction to medication?

The ICD-10 code for an adverse reaction to medication is typically in the range T36-T50, with a fifth character '5' indicating an adverse effect.

How do you document an adverse drug reaction?

Document the generic drug name, specific symptoms, timing of reaction, and any diagnostic confirmation to ensure accurate coding and billing.

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