2024 ICD-10-CM Diagnosis Code T42.6X5D

Adverse effect of other antiepileptic and sedative-hypnotic drugs, subsequent encounter

ICD-10-CM Code:
T42.6X5D
ICD-10 Code for:
Adverse effect of antiepileptic and sed-hypntc drugs, 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 antiepileptic, sedative- hypnotic and antiparkinsonism drugs
        (T42)

T42.6X5D is a billable diagnosis code used to specify a medical diagnosis of adverse effect of other antiepileptic and sedative-hypnotic 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.

T42.6X5D 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 antiepileptic and sedative-hypnotic 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:

  • Acne of external chemical origin
  • Acneiform eruption
  • Acneiform eruption due to bromine compound
  • Acneiform eruption due to chemical
  • Adverse reaction caused by bromine and/or bromine compound
  • Adverse reaction caused by bromine and/or bromine compound
  • Adverse reaction caused by bromine and/or bromine compound
  • Adverse reaction to aldehyde
  • Adverse reaction to aldehyde
  • Adverse reaction to aldehyde
  • Adverse reaction to carbromal
  • Adverse reaction to chloral and/or chloral derivative
  • Adverse reaction to glutethimide
  • Adverse reaction to methaqualone
  • Anticonvulsant drug-induced osteomalacia
  • Barbiturate antiepileptic adverse reaction
  • Beclamide adverse reaction
  • Bromine acne
  • Bromoderma
  • Carbamate sedative adverse reaction
  • Chloral hydrate adverse reaction
  • Chlormethiazole adverse reaction
  • Chlormezanone adverse reaction
  • Congenital malformation caused by valproic acid
  • Fetal disorder caused by anticonvulsant via placental transfer
  • Fetal valproate syndrome
  • Gabapentin adverse reaction
  • Halogen acne
  • Halogen eruption
  • Halogen eruption
  • Lamotrigine adverse reaction
  • Metabolic acidosis due to paraldehyde
  • Methyprylone adverse reaction
  • Osteomalacia secondary to drug
  • Paraldehyde adverse reaction
  • Piracetam adverse reaction
  • Primidone adverse reaction
  • Propionic acid derivative adverse reaction
  • Sodium valproate adverse reaction
  • Triclofos sodium adverse reaction
  • Vigabatrin adverse reaction
  • Zolpidem adverse reaction
  • Zopiclone adverse reaction

Clinical Classification

Clinical CategoryCCSR Category CodeInpatient Default CCSROutpatient Default CCSR
Adverse effects of drugs and medicaments, subsequent encounterINJ065X - Not applicable.Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Sedative-related disorders; subsequent encounterMBD032X - Not applicable.N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.

Clinical Information

  • Fetal Valproate Syndrome

    a teratogenic disorder observed in a newborn or child of a mother who was exposed to valproic acid during pregnancy. manifestations include musculoskeletal abnormalities, intellectual disability, spina bifida, and distinctive facial features.

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 antiepileptic, sedative- hypnotic and antiparkinsonism drugs (T42). 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)

T42.6X5D 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 T42.6X5D 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 T42.6X5 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
AcecarbromalT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
AcetylcarbromalT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
AcetylpheneturideT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
AllylisopropylacetylureaT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
AllyltribromideT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
ApronalideT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
AvomineT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
BarbexacloneT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
BeclamideT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Beta-ChlorT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Bromal (hydrate)T42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Bromide saltsT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
BromineT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Bromine
  »compounds (medicinal)
T42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Bromine
  »sedative
T42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Bromine
  »vapor
T42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
BromisovalT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
BromisovalumT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
BromoformT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
BromuralT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
BromvaletoneT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Butylchloral hydrateT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Carbamate (sedative)T42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Carbamate (sedative)
  »herbicide
T42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Carbamate (sedative)
  »insecticide
T42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
CarbromalT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
ChloralT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Chloral
  »derivative
T42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Chloral
  »hydrate
T42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
ChloralamideT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
ChloralodolT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
ChlorbutolT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
ChlorethiazolT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
ChloretoneT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
ChlorhexadolT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
ChlormethiazoleT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
ChlormezanoneT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
ClomethiazoleT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Cloral betaineT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
DichloralphenozoneT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Diethylsulfone-diethylmethaneT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
DivalproexT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
DoridenT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
DormisonT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
EctylureaT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
EthchlorvynolT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
EthinamateT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
EtifoxineT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
GlutethimideT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
HexapropymateT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Lactuca (virosa) (extract)T42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
LactucariumT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Lettuce opiumT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
LevanilT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
LevopromeT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
MeparfynolT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Methaqualone (compound)T42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
MethylparafynolT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Methylpentynol, methylpenthynolT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
MethyprylonT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
NiaprazineT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
NoctecT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
NoludarT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
ParacetaldehydeT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
ParaldehydeT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
PericlorT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
PetrichloralT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
PhenacemideT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
PhenerganT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
PheneturideT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
PhthalimidoglutarimideT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
PlacidylT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
PrimidoneT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
ProgabideT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Propionaldehyde (medicinal)T42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
PyrithyldioneT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
QuaaludeT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
SedormidT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
SerenesilT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
SomnosT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
SoporT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
SulfonalT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
SulfonethylmethaneT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
SulfonmethaneT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
SulthiameT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
SultiameT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
TetronalT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
ToloxatoneT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
TribromacetaldehydeT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
TribromomethaneT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
TrichloroethanolT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Trichloroethyl phosphateT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
TriclofosT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
TrionalT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
TripleT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Triple
  »bromides
T42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Triple
  »carbonate
T42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Triple
  »vaccine
T42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Triple
  »vaccine
    »DPT
T42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Triple
  »vaccine
    »including pertussis
T42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Triple
  »vaccine
    »MMR
T42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
ValerianT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Valerian
  »root
T42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Valerian
  »tincture
T42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
ValmidT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
ValnoctamideT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Valproate (sodium)T42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
Valproic acidT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
ValpromideT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
VigabatrinT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
WelldormT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
ZolpidemT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6
ZopicloneT42.6X1T42.6X2T42.6X3T42.6X4T42.6X5T42.6X6

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.