2024 ICD-10-CM Diagnosis Code T42.6X6D
Underdosing of other antiepileptic and sedative-hypnotic drugs, subsequent encounter
- ICD-10-CM Code:
- T42.6X6D
- ICD-10 Code for:
- Underdosing of antiepileptic and sed-hypntc drugs, subs
- Is Billable?
- Yes - Valid for Submission
- Chronic Condition Indicator: [1]
- Not chronic
- Code Navigator:
T42.6X6D is a billable diagnosis code used to specify a medical diagnosis of underdosing of other antiepileptic and sedative-hypnotic drugs, subsequent encounter. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
This code describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.
T42.6X6D is a subsequent encounter code, includes a 7th character and should be used after the patient has completed active treatment for a condition like underdosing of other antiepileptic and sedative-hypnotic drugs. According to ICD-10-CM Guidelines a "subsequent encounter" occurs when the patient is receiving routine care for the condition during the healing or recovery phase of treatment. Subsequent diagnosis codes are appropriate during the recovery phase, no matter how many times the patient has seen the provider for this condition. If the provider needs to adjust the patient's care plan due to a setback or other complication, the encounter becomes active again.
Clinical Classification
Clinical Category is Underdosing of drugs and medicaments, subsequent encounter
- CCSR Category Code: INJ066
- Inpatient Default CCSR: X - Not applicable.
- Outpatient Default CCSR: X - Not applicable.
Clinical Information
Bromine
a halogen with the atomic symbol br, atomic number 35, and atomic weight 79.904. it is a volatile reddish-brown liquid that gives off suffocating vapors, is corrosive to the skin, and may cause severe gastroenteritis if ingested.Bromine Compounds
inorganic compounds that contain bromine as an integral part of the molecule.Bromine Radioisotopes
unstable isotopes of bromine that decay or disintegrate emitting radiation. br atoms with atomic weights 74-78, 80, and 82-90 are radioactive bromine isotopes.Bromisovalum
a sedative and mild hypnotic with potentially toxic effects.Chlormethiazole
a sedative and anticonvulsant often used in the treatment of alcohol withdrawal. chlormethiazole has also been proposed as a neuroprotective agent. the mechanism of its therapeutic activity is not entirely clear, but it does potentiate gamma-aminobutyric acid receptors response and it may also affect glycine receptors.Chlormezanone
a non-benzodiazepine that is used in the management of anxiety. it has been suggested for use in the treatment of muscle spasm.Ethchlorvynol
a sedative and hypnotic that has been used in the short-term management of insomnia. its use has been superseded by other drugs.Glutethimide
a hypnotic and sedative. its use has been largely superseded by other drugs.Paraldehyde
a hypnotic and sedative with anticonvulsant effects. however, because of the hazards associated with its administration, its tendency to react with plastic, and the risks associated with its deterioration, it has largely been superseded by other agents. it is still occasionally used to control status epilepticus resistant to conventional treatment. (from martindale, the extra pharmacopoeia, 30th ed, p608-9)Primidone
a barbiturate derivative that acts as a gaba modulator and anti-epileptic agent. it is partly metabolized to phenobarbital in the body and owes some of its actions to this metabolite.Dipsacales
an order of dicotyledonous flowering plants which includes six families. it is best known for its ornamental plants such as lonicera (honeysuckle), viburnum (arrowwood and guelder rose), and scabiosa (scabious, or pincushion flower).Valerian
a plant genus of the family valerianaceae, order dipsacales, subclass asteridae, class magnoliopsida. it is best known for the sedative use and valepotriate content of the roots. it is sometimes called garden heliotrope but is unrelated to true heliotrope (heliotropium).Valerianaceae
the valerian plant family of the order dipsacales, subclass asteridae, class magnoliopsida that is characterized by 3-5-lobed tubular flowers, often spurred at the base and clustered in tight heads.Valerianella
a plant genus of the family valerianaceae. it is sometimes called goosefoot cornsalad but should not be confused with true goosefoot (chenopodium).Valproic Acid
a fatty acid with anticonvulsant and anti-manic properties that is used in the treatment of epilepsy and bipolar disorder. the mechanisms of its therapeutic actions are not well understood. it may act by increasing gamma-aminobutyric acid levels in the brain or by altering the properties of voltage-gated sodium channels.Vigabatrin
an analogue of gamma-aminobutyric acid. it is an irreversible inhibitor of 4-aminobutyrate transaminase, the enzyme responsible for the catabolism of gamma-aminobutyric acid and is used as an anticonvulsant. (from martindale the extra pharmacopoeia, 31st ed)Zolpidem
an imidazopyridine derivative and short-acting gaba-a receptor agonist that is used for the treatment of insomnia.
Coding Guidelines
Underdosing refers to taking less of a medication than is prescribed by a provider or a manufacturer's instruction. Codes for underdosing should never be assigned as principal or first-listed codes. If a patient has a relapse or exacerbation of the medical condition for which the drug is prescribed because of the reduction in dose, then the medical condition itself should be coded.
The appropriate 7th character is to be added to each code from block Poisoning by, adverse effect of and underdosing of antiepileptic, sedative- hypnotic and antiparkinsonism drugs (T42). Use the following options for the aplicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
Code Edits
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:
- Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.
Present on Admission (POA)
T42.6X6D is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.
CMS POA Indicator Options and Definitions
POA Indicator | Reason for Code | CMS will pay the CC/MCC DRG? |
---|---|---|
Y | Diagnosis was present at time of inpatient admission. | YES |
N | Diagnosis was not present at time of inpatient admission. | NO |
U | Documentation insufficient to determine if the condition was present at the time of inpatient admission. | NO |
W | Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission. | YES |
1 | Unreported/Not used - Exempt from POA reporting. | NO |
Table of Drugs and Chemicals
The parent code T42.6X6 of the current diagnosis 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.
Patient Education
Medication Errors
Medicines treat infectious diseases, prevent problems from chronic diseases, and ease pain. But medicines can also cause harmful reactions if not used correctly. Errors can happen in the hospital, at the health care provider's office, at the pharmacy, or at home. You can help prevent errors by:
- Knowing your medicines. When you get a prescription, ask the name of the medicine and check to make sure that the pharmacy gave you the right medicine. Make sure that you understand how often you should take the medicine and how long you should take it.
- Keeping a list of medicines.
- Write down all of the medicines that you are taking, including the names of your medicines, how much you take, and when you take them. Make sure to include any over-the-counter medicines, vitamins, supplements, and herbs that you take.
- List the medicines that you are allergic to or that have caused you problems in the past.
- Take this list with you every time you see a health care provider.
- Reading medicine labels and following the directions. Don't just rely on your memory - read the medication label every time. Be especially careful when giving medicines to children.
- Asking questions. If you don't know the answers to these questions, ask your health care provider or pharmacist:
- Why am I taking this medicine?
- What are the common side effects?
- What should I do if I have side effects?
- When should I stop this medicine?
- Can I take this medicine with the other medicines and supplements on my list?
- Do I need to avoid certain foods or alcohol while taking this medicine?
Food and Drug Administration
[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.
Footnotes
[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.