2024 ICD-10-CM Diagnosis Code T48.4X6D

Underdosing of expectorants, subsequent encounter

ICD-10-CM Code:
T48.4X6D
ICD-10 Code for:
Underdosing of expectorants, subsequent encounter
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Not chronic
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 agents primarily acting on smooth and skeletal muscles and the respiratory system
        (T48)

T48.4X6D is a billable diagnosis code used to specify a medical diagnosis of underdosing of expectorants, 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.

T48.4X6D 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 expectorants. 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 Information

  • Acetylcysteine

    the n-acetyl derivative of cysteine. it is used as a mucolytic agent to reduce the viscosity of mucous secretions. it has also been shown to have antiviral effects in patients with hiv due to inhibition of viral stimulation by reactive oxygen intermediates.
  • Ambroxol

    a metabolite of bromhexine that stimulates mucociliary action and clears the air passages in the respiratory tract. it is usually administered as the hydrochloride.
  • Bromhexine

    a mucolytic agent used in the treatment of respiratory disorders associated with viscid or excessive mucus. (from martindale, the extra pharmacopoeia, 30th ed, p744)
  • Glycyrrhizic Acid

    a widely used anti-inflammatory agent isolated from the licorice root. it is metabolized to glycyrrhetinic acid, which inhibits 11-beta-hydroxysteroid dehydrogenases and other enzymes involved in the metabolism of corticosteroids. therefore, glycyrrhizic acid, which is the main and sweet component of licorice, has been investigated for its ability to cause hypermineralocorticoidism with sodium retention and potassium loss, edema, increased blood pressure, as well as depression of the renin-angiotensin-aldosterone system.
  • Guaifenesin

    an expectorant that also has some muscle relaxing action. it is used in many cough preparations.

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 agents primarily acting on smooth and skeletal muscles and the respiratory system (T48). 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)

T48.4X6D 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 IndicatorReason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert T48.4X6D to ICD-9-CM

  • ICD-9-CM Code: -
    No Map Flag -

Table of Drugs and Chemicals

The parent code T48.4X6 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
AcetylcysteineT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
AmbroxolT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
BromhexineT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
CarbocisteineT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
S-Carboxymethyl-cysteineT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Cough mixture (syrup)T48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Cough mixture (syrup)
  »containing opiates
T48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Cough mixture (syrup)
  »expectorants
T48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Deglycyrrhizinized extract of licoriceT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
DomiodolT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
DornaseT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
EprazinoneT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Expectorant NECT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
GlycerylT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Glyceryl
  »gualacolate
T48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Glyceryl
  »nitrate
T48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Glyceryl
  »triacetate (topical)
T48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Glyceryl
  »trinitrate
T48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Glycyrrhiza extractT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Glycyrrhizic acidT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Glycyrrhizinate potassiumT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Guaiacol derivativesT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
GuaifenesinT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
GuaimesalT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
GuaiphenesinT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Hydriodic acidT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
IpecacuanhaT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
LetosteineT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
LiquoriceT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Liquorice
  »extract
T48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
MecysteineT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
MesnaT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Mucolytic drugT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
MucomystT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
OrganidinT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Quillaja extractT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
RespaireT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Senega syrupT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
SobrerolT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Sputum viscosity-lowering drugT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
SteproninT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
SulfogaiacolT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
SuperinoneT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
TenoglicinT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Terpin (cis) hydrateT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
TyloxapolT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6

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


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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.