2024 ICD-10-CM Diagnosis Code T45.615D
Adverse effect of thrombolytic drugs, subsequent encounter
- ICD-10-CM Code:
- T45.615D
- ICD-10 Code for:
- Adverse effect of thrombolytic drugs, subsequent encounter
- Is Billable?
- Yes - Valid for Submission
- Chronic Condition Indicator: [1]
- Not chronic
- Code Navigator:
- Code Information
- Approximate Synonyms
- Clinical Classification
- Clinical Information
- Coding Guidelines
- Tabular List of Diseases and Injuries
- Code Edits
- Diagnostic Related Groups Mapping
- Present on Admission (POA)
- Convert to ICD-9 Code
- Table of Drugs and Chemicals
- Patient Education
- Other Codes Used Similar Conditions
- Code History
T45.615D is a billable diagnosis code used to specify a medical diagnosis of adverse effect of thrombolytic 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.
T45.615D is a subsequent encounter code, includes a 7th character and should be used after the patient has completed active treatment for a condition like adverse effect of thrombolytic 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.
Approximate Synonyms
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Adverse reaction to fibrinolytic drugs
- Alteplase adverse reaction
- Anistreplase adverse reaction
- Drug-induced fibrinolytic disorder
- Fibrinolytic disorder caused by tissue plasminogen activator
- Fibrinolytic disorder caused by urokinase
- Hemorrhage after administration of thrombolytic agent
- Intracranial hemorrhage following administration of thrombolytic agent
- Streptokinase adverse reaction
- Streptokinase streptodornase adverse reaction
- Urokinase adverse reaction
Clinical Classification
Clinical Category is Adverse effects of drugs and medicaments, subsequent encounter
- CCSR Category Code: INJ065
- Inpatient Default CCSR: X - Not applicable.
- Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Clinical Information
Anistreplase
an acylated inactive complex of streptokinase and human lysine-plasminogen. after injection, the acyl group is slowly hydrolyzed, producing an activator that converts plasminogen to plasmin, thereby initiating fibrinolysis. its half-life is about 90 minutes compared to 5 minutes for tpa; (tissue plasminogen activator); 16 minutes for urokinase-type plasminogen activator and 23 minutes for streptokinase. if treatment is initiated within 3 hours of onset of symptoms for acute myocardial infarction, the drug preserves myocardial tissue and left ventricular function and increases coronary artery patency. bleeding complications are similar to other thrombolytic agents.Streptodornase and Streptokinase
a mixture of the enzymes (streptokinase and streptodornase) produced by hemolytic streptococci. it is used topically on surface lesions and by instillation in closed body cavities to remove clotted blood or fibrinous or purulent accumulations. it is also used as a skin test antigen in evaluating generalized cell-mediated immunodeficiency. (dorland, 27th ed) ec 3.-.Streptokinase
streptococcal fibrinolysin . an enzyme produced by hemolytic streptococci. it hydrolyzes amide linkages and serves as an activator of plasminogen. it is used in thrombolytic therapy and is used also in mixtures with streptodornase (streptodornase and streptokinase). ec 3.4.-.
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 primarily systemic and hematological agents, not elsewhere classified (T45). 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)
T45.615D 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 |
Convert T45.615D to ICD-9-CM
- ICD-9-CM Code: V58.89 - Other specfied aftercare
Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.
Table of Drugs and Chemicals
The parent code T45.615 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.
Substance | Poisoning Accidental (unintentional) |
Poisoning Accidental (self-harm) |
Poisoning Assault |
Poisoning Undetermined |
Adverse effect |
Underdosing |
---|---|---|---|---|---|---|
Alteplase | T45.611 | T45.612 | T45.613 | T45.614 | T45.615 | T45.616 |
Anistreplase | T45.611 | T45.612 | T45.613 | T45.614 | T45.615 | T45.616 |
Fibrinolytic drug | T45.611 | T45.612 | T45.613 | T45.614 | T45.615 | T45.616 |
Plasminogen (tissue) activator | T45.611 | T45.612 | T45.613 | T45.614 | T45.615 | T45.616 |
Rt-PA | T45.611 | T45.612 | T45.613 | T45.614 | T45.615 | T45.616 |
Streptokinase | T45.611 | T45.612 | T45.613 | T45.614 | T45.615 | T45.616 |
Thrombolysin | T45.611 | T45.612 | T45.613 | T45.614 | T45.615 | T45.616 |
Urokinase | T45.611 | T45.612 | T45.613 | T45.614 | T45.615 | T45.616 |
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.
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.