2024 ICD-10-CM Diagnosis Code T37.5X5S
Adverse effect of antiviral drugs, sequela
- ICD-10-CM Code:
- T37.5X5S
- ICD-10 Code for:
- Adverse effect of antiviral drugs, sequela
- 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
T37.5X5S is a billable diagnosis code used to specify a medical diagnosis of adverse effect of antiviral drugs, sequela. 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.
T37.5X5S is a sequela code, includes a 7th character and should be used for complications that arise as a direct result of a condition like adverse effect of antiviral drugs. According to ICD-10-CM Guidelines a "sequela" code should be used for chronic or residual conditions that are complications of an initial acute disease, illness or injury. The most common sequela is pain. Usually, two diagnosis codes are needed when reporting sequela. The first code describes the nature of the sequela while the second code describes the sequela or late effect.
Approximate Synonyms
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Aciclovir adverse reaction
- Adverse reaction to bebtelovimab
- Adverse reaction to casirivimab
- Adverse reaction to casirivimab and/or imdevimab
- Adverse reaction to dimethyl sulfoxide and/or idoxuridine
- Adverse reaction to dimethyl sulfoxide and/or idoxuridine
- Adverse reaction to imdevimab
- Adverse reaction to interferon gamma-1b
- Adverse reaction to remdesivir
- Adverse reaction to sotrovimab
- Anemia caused by zidovudine
- Antiviral drug adverse reaction
- Cidofovir-induced anterior uveitis
- Didanosine adverse reaction
- Disorder of cellular component of blood caused by antiretroviral drug
- Disorder of cellular component of blood caused by antiretroviral drug
- Disorder of gastrointestinal tract caused by antiretroviral drug
- Drug-induced uveitis
- Eruption of skin caused by antiretroviral drug
- Famciclovir adverse reaction
- Foscarnet adverse reaction
- Ganciclovir adverse reaction
- Idoxuridine adverse reaction
- Indinavir urolithiasis
- Inosine pranobex adverse reaction
- Interferon-A-2a adverse reaction
- Interferon-A-2b adverse reaction
- Interferon-A-N1 adverse reaction
- Interferons adverse reaction
- Lipoatrophy caused by antiretroviral drug
- Lipodystrophy caused by antiretroviral drug
- Nodular hyperplasia of liver
- Nodular regenerative hyperplasia of liver
- Nodular regenerative hyperplasia of liver caused by antiretroviral drug
- Nodule of liver
- Phlebosclerosis
- Portal and splenic vein sclerosis
- Portal hypertension
- Portal hypertension caused by antiretroviral drug
- Sclerosis of portal vein and splenic vein caused by antiretroviral drug
- Sleep disorder caused by reverse transcriptase inhibitor
- Steatosis of liver caused by retroviral protease inhibitor
- Tribavirin adverse reaction
- Trifluorothymidine adverse reaction
- Valaciclovir adverse reaction
- Vidarabine adverse reaction
- Zalcitabine adverse reaction
- Zidovudine adverse reaction
Clinical Classification
Clinical Category is Poisoning/toxic effect/adverse effects/underdosing, sequela
- CCSR Category Code: INJ075
- Inpatient Default CCSR: X - Not applicable.
- Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Clinical Information
Acyclovir
a guanosine analog that acts as an antimetabolite. viruses are especially susceptible. used especially against herpes.Valacyclovir
a prodrug of acyclovir that is used in the treatment of herpes zoster and herpes simplex virus infection of the skin and mucous membranes, including genital herpes.Inosine Pranobex
an alkylamino-alcohol complex of inosine used in the treatment of a variety of viral infections. unlike other antiviral agents, it acts by modifying or stimulating cell-mediated immune processes rather than acting on the virus directly.Methisazone
an antiviral agent effective against pox viruses.Ribavirin
a nucleoside antimetabolite antiviral agent that blocks nucleic acid synthesis and is used against both rna and dna viruses.Rimantadine
an rna synthesis inhibitor that is used as an antiviral agent in the prophylaxis and treatment of influenza.Thymopentin
synthetic pentapeptide corresponding to the amino acids 32-36 of thymopoietin and exhibiting the full biological activity of the natural hormone. it is an immunomodulator which has been studied for possible use in the treatment of rheumatoid arthritis, aids, and other primary immunodeficiencies.Trifluridine
an antiviral derivative of thymidine used mainly in the treatment of primary keratoconjunctivitis and recurrent epithelial keratitis due to herpes simplex virus. (from martindale, the extra pharmacopoeia, 30th ed, p557)Vidarabine
a nucleoside antibiotic isolated from streptomyces antibioticus. it has some antineoplastic properties and has broad spectrum activity against dna viruses in cell cultures and significant antiviral activity against infections caused by a variety of viruses such as the herpes viruses, the vaccinia virus and varicella zoster virus.Vidarabine Phosphate
an adenosine monophosphate analog in which ribose is replaced by an arabinose moiety. it is the monophosphate ester of vidarabine with antiviral and possibly antineoplastic properties.Zalcitabine
a dideoxynucleoside compound in which the 3'-hydroxy group on the sugar moiety has been replaced by a hydrogen. this modification prevents the formation of phosphodiester linkages which are needed for the completion of nucleic acid chains. the compound is a potent inhibitor of hiv replication at low concentrations, acting as a chain-terminator of viral dna by binding to reverse transcriptase. its principal toxic side effect is axonal degeneration resulting in peripheral neuropathy.Zidovudine
a dideoxynucleoside compound in which the 3'-hydroxy group on the sugar moiety has been replaced by an azido group. this modification prevents the formation of phosphodiester linkages which are needed for the completion of nucleic acid chains. the compound is a potent inhibitor of hiv replication, acting as a chain-terminator of viral dna during reverse transcription. it improves immunologic function, partially reverses the hiv-induced neurological dysfunction, and improves certain other clinical abnormalities associated with aids. its principal toxic effect is dose-dependent suppression of bone marrow, resulting in anemia and leukopenia.
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 other systemic anti-infectives and antiparasitics (T37). 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)
T37.5X5S 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 T37.5X5S to ICD-9-CM
- ICD-9-CM Code: 909.5 - Lte efct advrs efct drug
Combination Flag - Multiple codes are needed to describe the source diagnosis code. Correct coding should be done based on contextual judgment. - ICD-9-CM Code: E931.7 - Adv eff antiviral drugs
Combination Flag - Multiple codes are needed to describe the source diagnosis code. Correct coding should be done based on contextual judgment.
Table of Drugs and Chemicals
The parent code T37.5X5 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
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.