What is the ICD-10 code for adverse drug reaction?

ICD-10 codes for adverse drug reactions are in the T36-T50 range.

How do you code a medication side effect in ICD-10?

To code a medication side effect in ICD-10, first code the manifestation of the side effect, then add the appropriate T36-T50 code for the adverse effect.

What is the ICD-10 code for adverse drug reaction?

ICD-10 codes for adverse drug reactions are found in the T36-T50 range, depending on the specific drug and effect.

How do you code a medication side effect in ICD-10?

To code a medication side effect in ICD-10, first code the manifestation of the side effect, then add the appropriate T36-T50 code for the adverse effect.

What is the ICD-10 code for adverse drug reaction?

ICD-10 codes for adverse drug reactions are found in the T36-T50 range, depending on the specific drug and effect.

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ICD-10 Coding for Medication Side Effect(T45.AX5D, K52.1)

Complete ICD-10-CM coding and documentation guide for Medication Side Effect. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Drug ReactionAdverse Drug Effect

Related ICD-10 Code Ranges

Complete code families applicable to Medication Side Effect

T36-T50Primary Range

Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances

This range includes codes for adverse effects of drugs taken as prescribed, which is the primary focus for documenting medication side effects.

K52-K71

Diseases of the digestive system and liver due to drugs

These codes are used to document specific manifestations of drug-induced conditions, such as enteritis or hepatitis.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

Code	Description	When to Use	Key Documentation
T45.AX5D	Adverse effect of other primarily systemic and hematological agents, subsequent encounter	Use when documenting an adverse effect from a systemic agent taken as prescribed.	Documentation of drug administration as prescribed Description of adverse effect manifestation
K52.1	Toxic gastroenteritis and colitis	Use when documenting gastrointestinal manifestations of a drug-induced condition.	Gastrointestinal symptoms linked to drug intake Exclusion of other causes of gastroenteritis

Clinical Decision Support

Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.

Key Information: How to code medication side effects in ICD-10

Essential facts and insights about Medication Side Effect

To code medication side effects, start with the manifestation code, followed by the T36-T50 adverse effect code.

Primary ICD-10-CM Codes for medication side effect

T45.AX5D

Adverse effect of other primarily systemic and hematological agents, subsequent encounter

Billable Code

Decision Criteria

clinical Criteria

Adverse effect confirmed by clinical evaluation

documentation Criteria

Explicit mention of drug administration as prescribed

Applicable To

Adverse effect of immune checkpoint inhibitors

Excludes

Poisoning by immune checkpoint inhibitors

Clinical Validation Requirements

Documentation of drug administration as prescribed
Description of adverse effect manifestation

Code-Specific Risks

Incorrect sequencing with manifestation codes

Coding Notes

Ensure the adverse effect is documented as a result of the drug being taken as prescribed.

View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Toxic gastroenteritis and colitis

K52.1

Use to document specific gastrointestinal manifestations of drug-induced conditions.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Adverse effect of antineoplastic and immunosuppressive drugs, subsequent encounter

T45.1X5D

Use for adverse effects specifically from antineoplastic or immunosuppressive drugs.

Allergic and dietetic gastroenteritis and colitis

K52.2

Use for non-drug related allergic reactions.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Medication Side Effect to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code T45.AX5D.

Impact

Clinical: Leads to misinterpretation of patient condition., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials due to insufficient detail.

Mitigation Strategy

Use specific language linking drug to effect., Include all relevant clinical details.

Impact

Reimbursement: Incorrect sequencing can lead to claim denials., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data representation.

Mitigation Strategy

Always code the manifestation first, followed by the adverse effect code.

Impact

Incorrect sequencing of adverse effect and manifestation codes.

Mitigation Strategy

Regular training on ICD-10 coding guidelines.

Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.

Frequently Asked Questions

Common questions about ICD-10 coding for Medication Side Effect, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Medication Side Effect

Use these documentation templates to ensure complete and accurate documentation for Medication Side Effect. These templates include all required elements for proper coding and billing.

Adverse effect of chemotherapy

Specialty: Oncology

Required Elements

Drug name and dosage
Adverse effect description
Management and treatment plan

Example Documentation

Patient received pembrolizumab 200mg IV for melanoma. Developed severe diarrhea, confirmed as drug-induced. Treatment: Loperamide initiated.

Examples: Poor vs. Good Documentation

Poor Documentation Example

Patient had reaction to chemo.

Good Documentation Example

Patient developed severe diarrhea (R19.7) due to pembrolizumab (T45.AX5D) for melanoma (C43.9).

Explanation

The good example specifies the drug, adverse effect, and condition treated, ensuring clear documentation.

Need help with ICD-10 coding for Medication Side Effect? Ask your questions below.

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ICD-10 Coding for Medication Side Effect(T45.AX5D, K52.1)

Quick Navigation

Related ICD-10 Code Ranges

T36-T50Primary Range

K52-K71

Code Comparison: When to Use Each Code

Clinical Decision Support

Key Information: How to code medication side effects in ICD-10

Primary ICD-10-CM Codes for medication side effect

Decision Criteria

clinical Criteria

documentation Criteria

Applicable To

Excludes

Clinical Validation Requirements

Code-Specific Risks

Coding Notes

K52.1 - Toxic gastroenteritis and colitis

Applicable To

Excludes

Clinical Validation Requirements

Coding Notes

Ancillary Codes

Differential Codes

Documentation & Coding Risks

Vague documentation of drug reactions

Impact

Mitigation Strategy

Incorrect sequencing of codes

Impact

Mitigation Strategy

Code Sequencing

Impact

Mitigation Strategy

Frequently Asked Questions

Documentation Templates for Medication Side Effect

Adverse effect of chemotherapy

Required Elements

Example Documentation

Examples: Poor vs. Good Documentation

Poor Documentation Example

Good Documentation Example

Explanation

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Helpful Links

We build tools for
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