2024 ICD-10-CM Diagnosis Code T38.1X6S

Underdosing of thyroid hormones and substitutes, sequela

ICD-10-CM Code:
T38.1X6S
ICD-10 Code for:
Underdosing of thyroid hormones and substitutes, sequela
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 hormones and their synthetic substitutes and antagonists, not elsewhere classified
        (T38)

T38.1X6S is a billable diagnosis code used to specify a medical diagnosis of underdosing of thyroid hormones and substitutes, 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.

T38.1X6S is a sequela code, includes a 7th character and should be used for complications that arise as a direct result of a condition like underdosing of thyroid hormones and substitutes. 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.

Clinical Classification

Clinical Information

  • Correspondence as Topic

    works on written communication between persons or between institutions or organizations.
  • Histiocytosis, Langerhans-Cell

    a group of disorders resulting from the abnormal proliferation of and tissue infiltration by langerhans cells which can be detected by their characteristic birbeck granules (x bodies), or by monoclonal antibody staining for their surface cd1 antigens. langerhans-cell granulomatosis can involve a single organ, or can be a systemic disorder.
  • Letter

    work consisting of written or printed communication between individuals or between persons and representatives of corporate bodies. the correspondence may be personal or professional. in medical and other scientific publications the letter is usually from one or more authors to the editor of the journal or book publishing the item being commented upon or discussed. letter is often accompanied by comment.
  • Thyroglobulin

  • Iodide Peroxidase

    a hemeprotein that catalyzes the oxidation of the iodide radical to iodine with the subsequent iodination of many organic compounds, particularly proteins. ec 1.11.1.8.
  • Receptors, Thyroid Hormone

    specific high affinity binding proteins for thyroid hormones in target cells. they are usually found in the nucleus and regulate dna transcription. these receptors are activated by hormones that leads to transcription, cell differentiation, and growth suppression. thyroid hormone receptors are encoded by two genes (genes, erba): erba-alpha and erba-beta for alpha and beta thyroid hormone receptors, respectively.
  • Thyroxine

    the major hormone derived from the thyroid gland. thyroxine is synthesized via the iodination of tyrosines (monoiodotyrosine) and the coupling of iodotyrosines (diiodotyrosine) in the thyroglobulin. thyroxine is released from thyroglobulin by proteolysis and secreted into the blood. thyroxine is peripherally deiodinated to form triiodothyronine which exerts a broad spectrum of stimulatory effects on cell metabolism.
  • Thyroxine-Binding Globulin

    a thyroid hormone transport protein found in serum. it binds about 75% of circulating thyroxine and 70% of circulating triiodothyronine.
  • Thyroxine-Binding Proteins

    blood proteins that bind to thyroid hormones such as thyroxine and transport them throughout the circulatory system.
  • Triiodothyronine

    a t3 thyroid hormone normally synthesized and secreted by the thyroid gland in much smaller quantities than thyroxine (t4). most t3 is derived from peripheral monodeiodination of t4 at the 5' position of the outer ring of the iodothyronine nucleus. the hormone finally delivered and used by the tissues is mainly t3.
  • Triiodothyronine, Reverse

    a metabolite of thyroxine, formed by the peripheral enzymatic monodeiodination of t4 at the 5 position of the inner ring of the iodothyronine nucleus.

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 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

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)

T38.1X6S 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 T38.1X6S to ICD-9-CM

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

Table of Drugs and Chemicals

The parent code T38.1X6 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
CytomelT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
DetrothyronineT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
DextrothyroxinT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
Dextrothyroxine sodiumT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
EuthroidT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
I-thyroxine sodiumT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
LetterT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
LevoidT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
LevothyroxineT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
Levothyroxine
  »sodium
T38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
LiothyronineT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
LiotrixT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
ProloidT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
SynthroidT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
ThyroglobulinT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
Thyroid (hormone)T38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
ThyrolarT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
ThyroxineT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
TiratricolT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
TitroidT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
TriiodothyronineT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6

Patient Education


Hormones

Hormones are your body's chemical messengers. They travel in your bloodstream to tissues or organs. They work slowly, over time, and affect many different processes, including:

  • Growth and development
  • Metabolism - how your body gets energy from the foods you eat
  • Sexual function
  • Reproduction
  • Mood

Endocrine glands, which are special groups of cells, make hormones. The major endocrine glands are the pituitary, pineal, thymus, thyroid, adrenal glands, and pancreas. In addition, men produce hormones in their testes and women produce them in their ovaries.

Hormones are powerful. It takes only a tiny amount to cause big changes in cells or even your whole body. That is why too much or too little of a certain hormone can be serious. Laboratory tests can measure the hormone levels in your blood, urine, or saliva. Your health care provider may perform these tests if you have symptoms of a hormone disorder. Home pregnancy tests are similar - they test for pregnancy hormones in your urine.


[Learn More in MedlinePlus]

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.