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  6. 2024 ICD-10-CM Code T38.3X5

2024 ICD-10-CM Diagnosis Code T38.3X5

Adverse effect of insulin and oral hypoglycemic [antidiabetic] drugs

ICD-10-CM Code:
T38.3X5
ICD-10 Code for:
Adverse effect of insulin and oral hypoglycemic drugs
Is Billable?
Not Valid for Submission
Code Navigator:

Code Classification

  • Injury, poisoning and certain other consequences of external causes
    (S00–T88)
    • Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances
      (T36-T50)
      • Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified
        (T38)

T38.3X5 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of adverse effect of insulin and oral hypoglycemic [antidiabetic] drugs. The code is not specific and is NOT valid for the year 2024 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.

Specific Coding Applicable to Adverse effect of insulin and oral hypoglycemic drugs

Non-specific codes like T38.3X5 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10-CM codes with a higher level of specificity when coding for adverse effect of insulin and oral hypoglycemic drugs:

  • Use T38.3X5A for initial encounter - BILLABLE CODE

  • Use T38.3X5D for subsequent encounter - BILLABLE CODE

  • Use T38.3X5S for sequela - BILLABLE CODE

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Acarbose adverse reaction
  • Acetohexamide adverse reaction
  • Adverse reaction caused by human insulin
  • Adverse reaction following injection of substance
  • Adverse reaction following injection of substance
  • Adverse reaction to antidiabetic drug
  • Adverse reaction to biguanide oral hypoglycemic agent
  • Adverse reaction to sulfonyluric hypoglycemic
  • Adverse reaction to zinc insulin
  • Biguanide adverse reaction
  • Chlorpropamide adverse reaction
  • Diabetic drug side effects
  • Drug-induced anaphylaxis
  • Fat hypertrophy
  • Glibenclamide adverse reaction
  • Glibornuride adverse reaction
  • Gliclazide adverse reaction
  • Glipizide adverse reaction
  • Gliquidone adverse reaction
  • Glucagon adverse reaction
  • Glymidine adverse reaction
  • Insulin adverse reaction
  • Insulin adverse reaction
  • Insulin adverse reaction
  • Insulin adverse reaction
  • Insulin lipoatrophy
  • Insulin lipohypertrophy
  • Insulin-induced anaphylaxis
  • Isophane insulin adverse reaction
  • Lipoatrophy due to injected drug
  • Localized lipoatrophy
  • Metformin adverse reaction
  • Protamine zinc insulin adverse reaction
  • Regular insulin adverse reaction
  • Sulfonylurea adverse reaction
  • Tolazamide adverse reaction
  • Tolbutamide adverse reaction

Clinical Information

  • Acetohexamide

    a sulfonylurea hypoglycemic agent that is metabolized in the liver to 1-hydrohexamide.

  • Buformin

    an oral hypoglycemic agent that inhibits gluconeogenesis, increases glycolysis, and decreases glucose oxidation.

  • Carbutamide

    a sulfonylurea antidiabetic agent with similar actions and uses to chlorpropamide. (from martindale, the extra pharmacopoeia, 30th ed, p277)

  • Chlorpropamide

    a sulfonylurea hypoglycemic agent used in the treatment of non-insulin-dependent diabetes mellitus not responding to dietary modification. (from martindale, the extra pharmacopoeia, 30th ed, p277)

  • Gliclazide

    an oral sulfonylurea hypoglycemic agent which stimulates insulin secretion.

  • Glipizide

    an oral hypoglycemic agent which is rapidly absorbed and completely metabolized.

  • Glucagon

    a 29-amino acid pancreatic peptide derived from proglucagon which is also the precursor of intestinal glucagon-like peptides. glucagon is secreted by pancreatic alpha cells and plays an important role in regulation of blood glucose concentration, ketone metabolism, and several other biochemical and physiological processes. (from gilman et al., goodman and gilman's the pharmacological basis of therapeutics, 9th ed, p1511)

  • Glucagon-Like Peptide 1

    a peptide of 36 or 37 amino acids that is derived from proglucagon and mainly produced by the intestinal l cells. glp-1(1-37 or 1-36) is further n-terminally truncated resulting in glp-1(7-37) or glp-1-(7-36) which can be amidated. these glp-1 peptides are known to enhance glucose-dependent insulin release, suppress glucagon release and gastric emptying, lower blood glucose, and reduce food intake.

  • Glucagon-Like Peptide 2

    a 33-amino acid peptide derived from the c-terminal of proglucagon and mainly produced by the intestinal l cells. it stimulates intestinal mucosal growth and decreased apoptosis of enterocytes. glp-2 enhances gastrointestinal function and plays an important role in nutrient homeostasis.

  • Glucagon-Like Peptide Receptors

    g-protein coupled cell surface receptors that bind glucagon-like peptides and are expressed by cells in pancreatic, intestinal, and neural tissues. these receptors regulate cellular responses to blood glucose, insulin, and inflammation signals.

  • Glucagon-Like Peptide-1 Receptor

    a receptor for glucagon-like peptide 1 (glp-1) expressed primarily on the surface of beta and ductal exocrine cells of the pancreas, as well as cells of other tissues. glp-1 acts through glp-1r to potentiate signaling in pancreatic cells in response to glucose-stimulated insulin secretion (gsis).

  • Glucagon-Like Peptide-2 Receptor

    a receptor for glucagon-like peptide 2 (glp-2) that is expressed on the surface of intestinal cells as well as neural cells. glp-2 and other peptides act through glp-2r to regulate cellular responses to blood glucose, inflammation, and food intake.

  • Glucagon-Like Peptides

    peptides derived from proglucagon which is also the precursor of pancreatic glucagon. despite expression of proglucagon in multiple tissues, the major production site of glucagon-like peptides (glps) is the intestinal l cells. glps include glucagon-like peptide 1, glucagon-like peptide 2, and the various truncated forms.

  • Glucagonoma

    an almost always malignant glucagon-secreting tumor derived from the pancreatic alpha cells. it is characterized by a distinctive migratory erythema; weight loss; stomatitis; glossitis; diabetes mellitus; hypoaminoacidemia; and normochromic normocytic anemia.

  • Glucagon-Secreting Cells

    a type of pancreatic cell representing about 5-20% of the islet cells. alpha cells secrete glucagon.

  • Proglucagon

    the common precursor polypeptide of pancreatic glucagon and intestinal glucagon-like peptides. proglucagon is the 158-amino acid segment of preproglucagon without the n-terminal signal sequence. proglucagon is expressed in the pancreas; intestines; and the central nervous system. posttranslational processing of proglucagon is tissue-specific yielding numerous bioactive peptides.

  • Receptors, Glucagon

    cell surface receptors that bind glucagon with high affinity and trigger intracellular changes which influence the behavior of cells. activation of glucagon receptors causes a variety of effects; the best understood is the initiation of a complex enzymatic cascade in the liver which ultimately increases the availability of glucose to body organs.

  • Glyburide

    an antidiabetic sulfonylurea derivative with actions like those of chlorpropamide

  • Metformin

    a biguanide hypoglycemic agent used in the treatment of non-insulin-dependent diabetes mellitus not responding to dietary modification. metformin improves glycemic control by improving insulin sensitivity and decreasing intestinal absorption of glucose. (from martindale, the extra pharmacopoeia, 30th ed, p289)

  • Phenformin

    a biguanide hypoglycemic agent with actions and uses similar to those of metformin. although it is generally considered to be associated with an unacceptably high incidence of lactic acidosis, often fatal, it is still available in some countries. (from martindale, the extra pharmacopoeia, 30th ed, p290)

  • Tolazamide

    a sulphonylurea hypoglycemic agent with actions and uses similar to those of chlorpropamide.

Coding Guidelines

When coding an adverse effect of a drug that has been correctly prescribed and properly administered, assign the appropriate code for the nature of the adverse effect followed by the appropriate code for the adverse effect of the drug.

The appropriate 7th character is to be added to each code from block Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified (T38). Use the following options for the aplicable episode of care:

  • A - initial encounter
  • D - subsequent encounter
  • S - sequela

Table of Drugs and Chemicals

The code is referenced in the Table of Drugs and Chemicals, this table contains a classification of drugs, industrial solvents, corrosive gases, noxious plants, pesticides, and other toxic agents.

According to ICD-10-CM coding guidelines it is advised to do not code directly from the Table of Drugs and Chemicals, instead always refer back to the Tabular List when doing the initial coding. Each substance in the table is assigned a code according to the poisoning classification and external causes of adverse effects. It is important to use as many codes as necessary to specify all reported drugs, medicinal or chemical substances. If the same diagnosis code describes the causative agent for more than one adverse reaction, poisoning, toxic effect or underdosing, utilize the code only once.

Substance Poisoning
Accidental
(unintentional)		 Poisoning
Accidental
(self-harm)		 Poisoning
Assault		 Poisoning
Undetermined		 Adverse
effect		 Underdosing
AcetohexamideT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Antidiabetic NECT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Antidiabetic NEC
  »biguanide
T38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Antidiabetic NEC
  »biguanide
    »and sulfonyl combined
T38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Antidiabetic NEC
  »combined
T38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Antidiabetic NEC
  »sulfonylurea
T38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Biguanide derivatives, oralT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
BuforminT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
CarbutamideT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
ChlorpropamideT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
DBIT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
DiabineseT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
DymelorT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Extended insulin zinc suspensionT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
GlibenclamideT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
GlibornurideT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
GliclazideT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
GlimidineT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
GlipizideT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
GliquidoneT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
GlisolamideT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
GlisoxepideT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Globin zinc insulinT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
GlucagonT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
GlyburideT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
GlyclopyramideT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
GlycyclamideT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Glymidine sodiumT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
IletinT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Insular tissue extractT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Insulin (amorphous) (globin) (isophane) (Lente) (NPH) (Semilente) (Ultralente)T38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Insulin (amorphous) (globin) (isophane) (Lente) (NPH) (Semilente) (Ultralente)
  »defalan
T38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Insulin (amorphous) (globin) (isophane) (Lente) (NPH) (Semilente) (Ultralente)
  »human
T38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Insulin (amorphous) (globin) (isophane) (Lente) (NPH) (Semilente) (Ultralente)
  »injection, soluble
T38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Insulin (amorphous) (globin) (isophane) (Lente) (NPH) (Semilente) (Ultralente)
  »injection, soluble
    »biphasic
T38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Insulin (amorphous) (globin) (isophane) (Lente) (NPH) (Semilente) (Ultralente)
  »intermediate acting
T38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Insulin (amorphous) (globin) (isophane) (Lente) (NPH) (Semilente) (Ultralente)
  »protamine zinc
T38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Insulin (amorphous) (globin) (isophane) (Lente) (NPH) (Semilente) (Ultralente)
  »slow acting
T38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Insulin (amorphous) (globin) (isophane) (Lente) (NPH) (Semilente) (Ultralente)
  »zinc
T38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Insulin (amorphous) (globin) (isophane) (Lente) (NPH) (Semilente) (Ultralente)
  »zinc
    »protamine injection
T38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Insulin (amorphous) (globin) (isophane) (Lente) (NPH) (Semilente) (Ultralente)
  »zinc
    »suspension (amorphous) (crystalline)
T38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Isophane insulinT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Lente lietin (insulin)T38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
MetforminT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Neutral insulin injectionT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
NPH lletin (insulin)T38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
OrinaseT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
PhenforminT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
PhenylethylbiguanideT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
PZIT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Sulfonylurea derivatives, oralT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
TolazamideT38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6
Tolbutamide (sodium)T38.3X1T38.3X2T38.3X3T38.3X4T38.3X5T38.3X6

Patient Education


Drug Reactions

Most of the time, medicines make our lives better. They reduce aches and pains, fight infections, and control problems such as high blood pressure or diabetes. But medicines can also cause unwanted reactions, such as drug interactions, side effects, and allergies.

What is a drug interaction?

A drug interaction is a change in the way a drug acts in the body when taken with certain other drugs, foods, or supplements or when taken while you have certain medical conditions. Examples include:

  • Two drugs, such as aspirin and blood thinners
  • Drugs and food, such as statins and grapefruit
  • Drugs and supplements, such as gingko and blood thinners
  • Drugs and medical conditions, such as aspirin and peptic ulcers

Interactions could cause a drug to be more or less effective, cause side effects, or change the way one or both drugs work.

What are side effects?

Side effects are unwanted, usually unpleasant, effects caused by medicines. Most are mild, such as a stomachache, dry mouth, or drowsiness, and go away after you stop taking the medicine. Others can be more serious. Sometimes a drug can interact with a disease that you have and cause a side effect. For example, if you have a heart condition, certain decongestants can cause you to have a rapid heartbeat.

What are drug allergies?

Drug allergies are another type of reaction. They can range from mild to life-threatening. Skin reactions, such as hives and rashes, are the most common type. Anaphylaxis, a serious allergic reaction, is less common.

How can I stay safe when taking medicines?

When you start a new prescription or over-the-counter medicine, make sure you understand how to take it correctly. Know which other medicines, foods, and supplements you need to avoid. Always talk to your health care provider or pharmacist if you have questions about your medicines.


[Learn More in MedlinePlus]

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.