2024 ICD-10-CM Diagnosis Code T38.895D

Adverse effect of other hormones and synthetic substitutes, subsequent encounter

ICD-10-CM Code:
T38.895D
ICD-10 Code for:
Adverse effect of hormones and synthetic substitutes, subs
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)

T38.895D is a billable diagnosis code used to specify a medical diagnosis of adverse effect of other hormones and synthetic substitutes, 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.

T38.895D 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 other hormones and synthetic substitutes. 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 caused by antidiuretic hormone
  • Adverse reaction to hypothalamic hormone
  • Adverse reaction to posterior pituitary hormones
  • Buserelin adverse reaction
  • Calcium regulating hormone adverse reaction
  • Cyclofenil adverse reaction
  • Desmopressin adverse reaction
  • Gonad regulating hormone adverse reaction
  • Gonadorelin adverse reaction
  • Gonadotrophic hormone adverse reaction
  • Hemostatic adverse reaction
  • Lypressin adverse reaction
  • Nafarelin adverse reaction
  • Protirelin adverse reaction
  • Sex hormones adverse reaction
  • Terlipressin adverse reaction
  • Thyrotropin releasing factor adverse reaction
  • Vasopressor adverse reaction

Clinical Classification

Clinical Information

  • Buserelin

    a potent synthetic analog of gonadotropin-releasing hormone with d-serine substitution at residue 6, glycine10 deletion, and other modifications.
  • Chorionic Gonadotropin

    a gonadotropic glycoprotein hormone produced primarily by the placenta. similar to the pituitary luteinizing hormone in structure and function, chorionic gonadotropin is involved in maintaining the corpus luteum during pregnancy. cg consists of two noncovalently linked subunits, alpha and beta. within a species, the alpha subunit is virtually identical to the alpha subunits of the three pituitary glycoprotein hormones (tsh, lh, and fsh), but the beta subunit is unique and confers its biological specificity (chorionic gonadotropin, beta subunit, human).
  • Chorionic Gonadotropin, beta Subunit, Human

    the beta subunit of human chorionic gonadotropin. its structure is similar to the beta subunit of luteinizing hormone, except for the additional 30 amino acids at the carboxy end with the associated carbohydrate residues. hcg-beta is used as a diagnostic marker for early detection of pregnancy, spontaneous abortion (abortion, spontaneous); ectopic pregnancy; hydatidiform mole; choriocarcinoma; or down syndrome.
  • Glycoprotein Hormones, alpha Subunit

    the alpha chain of pituitary glycoprotein hormones (thyrotropin; follicle stimulating hormone; luteinizing hormone) and the placental chorionic gonadotropin. within a species, the alpha subunits of these four hormones are identical; the distinct functional characteristics of these glycoprotein hormones are determined by the unique beta subunits. both subunits, the non-covalently bound heterodimers, are required for full biologic activity.
  • Receptors, LH

    those protein complexes or molecular sites on the surfaces and cytoplasm of gonadal cells that bind luteinizing or chorionic gonadotropic hormones and thereby cause the gonadal cells to synthesize and secrete sex steroids. the hormone-receptor complex is internalized from the plasma membrane and initiates steroid synthesis.
  • Felypressin

    a synthetic analog of lypressin with a phenylalanine substitution at residue 2. felypressin is a vasoconstrictor with reduced antidiuretic activity.
  • Leuprolide

    a potent synthetic long-acting agonist of gonadotropin-releasing hormone that regulates the synthesis and release of pituitary gonadotropins, luteinizing hormone and follicle stimulating hormone.
  • Lypressin

    the porcine antidiuretic hormone (vasopressins). it is a cyclic nonapeptide that differs from arg-vasopressin by one amino acid, containing a lysine at residue 8 instead of an arginine. lys-vasopressin is used to treat diabetes insipidus or to improve vasomotor tone and blood pressure.
  • Sermorelin

    the biologically active fragment of human growth hormone-releasing factor, consisting of ghrh(1-29)-amide. this n-terminal sequence is identical in several mammalian species, such as human, pig, and cattle. it is used to diagnose or treat patients with growth hormone deficiency.
  • Terlipressin

    an inactive peptide prodrug that is slowly converted in the body to lypressin. it is used to control bleeding of esophageal varices and for the treatment of hepatorenal syndrome.

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 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)

T38.895D 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 T38.895D 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 T38.895 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
ADHT38.891T38.892T38.893T38.894T38.895T38.896
Antidiuretic hormoneT38.891T38.892T38.893T38.894T38.895T38.896
BuserelinT38.891T38.892T38.893T38.894T38.895T38.896
Chorionic gonadotropinT38.891T38.892T38.893T38.894T38.895T38.896
DDAVPT38.891T38.892T38.893T38.894T38.895T38.896
Deamino-D-arginine vasopressinT38.891T38.892T38.893T38.894T38.895T38.896
DesmopressinT38.891T38.892T38.893T38.894T38.895T38.896
EnterogastroneT38.891T38.892T38.893T38.894T38.895T38.896
FelypressinT38.891T38.892T38.893T38.894T38.895T38.896
GonadorelinT38.891T38.892T38.893T38.894T38.895T38.896
GonadotropinT38.891T38.892T38.893T38.894T38.895T38.896
Gonadotropin
  »chorionic
T38.891T38.892T38.893T38.894T38.895T38.896
Gonadotropin
  »pituitary
T38.891T38.892T38.893T38.894T38.895T38.896
Hypophysis, posteriorT38.891T38.892T38.893T38.894T38.895T38.896
LeuprolideT38.891T38.892T38.893T38.894T38.895T38.896
LypressinT38.891T38.892T38.893T38.894T38.895T38.896
Lysine vasopressinT38.891T38.892T38.893T38.894T38.895T38.896
Melanocyte-stimulating hormoneT38.891T38.892T38.893T38.894T38.895T38.896
Pitressin (tannate)T38.891T38.892T38.893T38.894T38.895T38.896
Pituitary extracts (posterior)T38.891T38.892T38.893T38.894T38.895T38.896
Pituitary extracts (posterior)
  »anterior
T38.891T38.892T38.893T38.894T38.895T38.896
PituitrinT38.891T38.892T38.893T38.894T38.895T38.896
Placental hormoneT38.891T38.892T38.893T38.894T38.895T38.896
Posterior pituitary hormone NECT38.891T38.892T38.893T38.894T38.895T38.896
ProtirelinT38.891T38.892T38.893T38.894T38.895T38.896
SermorelinT38.891T38.892T38.893T38.894T38.895T38.896
SomatorelinT38.891T38.892T38.893T38.894T38.895T38.896
TerlipressinT38.891T38.892T38.893T38.894T38.895T38.896
Thymus extractT38.891T38.892T38.893T38.894T38.895T38.896
VasopressinT38.891T38.892T38.893T38.894T38.895T38.896
Vasopressor drugsT38.891T38.892T38.893T38.894T38.895T38.896

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.