2024 ICD-10-CM Diagnosis Code T44.1X6D
Underdosing of other parasympathomimetics [cholinergics], subsequent encounter
- ICD-10-CM Code:
- T44.1X6D
- ICD-10 Code for:
- Underdosing of other parasympath, subsequent encounter
- Is Billable?
- Yes - Valid for Submission
- Chronic Condition Indicator: [1]
- Not chronic
- Code Navigator:
T44.1X6D is a billable diagnosis code used to specify a medical diagnosis of underdosing of other parasympathomimetics [cholinergics], 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.
T44.1X6D 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 other parasympathomimetics [cholinergics]. 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 Category is Underdosing of drugs and medicaments, subsequent encounter
- CCSR Category Code: INJ066
- Inpatient Default CCSR: X - Not applicable.
- Outpatient Default CCSR: X - Not applicable.
Clinical Information
Acetylcholine
a neurotransmitter found at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system.Acetylcholine Release Inhibitors
compounds that block release of the neurotransmitter acetylcholine.Acetylcholinesterase
an enzyme that catalyzes the hydrolysis of acetylcholine to choline and acetate. in the cns, this enzyme plays a role in the function of peripheral neuromuscular junctions. ec 3.1.1.7.Cholinergic Agents
any drug used for its actions on cholinergic systems. included here are agonists and antagonists, drugs that affect the life cycle of acetylcholine, and drugs that affect the survival of cholinergic neurons. the term cholinergic agents is sometimes still used in the narrower sense of muscarinic agonists, although most modern texts discourage that usage.Cholinergic Agonists
drugs that bind to and activate cholinergic receptors.Cholinergic Antagonists
drugs that bind to but do not activate cholinergic receptors, thereby blocking the actions of acetylcholine or cholinergic agonists.Cholinesterase Inhibitors
drugs that inhibit cholinesterases. the neurotransmitter acetylcholine is rapidly hydrolyzed, and thereby inactivated, by cholinesterases. when cholinesterases are inhibited, the action of endogenously released acetylcholine at cholinergic synapses is potentiated. cholinesterase inhibitors are widely used clinically for their potentiation of cholinergic inputs to the gastrointestinal tract and urinary bladder, the eye, and skeletal muscles; they are also used for their effects on the heart and the central nervous system.Receptors, Cholinergic
cell surface proteins that bind acetylcholine with high affinity and trigger intracellular changes influencing the behavior of cells. cholinergic receptors are divided into two major classes, muscarinic and nicotinic, based originally on their affinity for nicotine and muscarine. each group is further subdivided based on pharmacology, location, mode of action, and/or molecular biology.Receptors, Muscarinic
one of the two major classes of cholinergic receptors. muscarinic receptors were originally defined by their preference for muscarine over nicotine. there are several subtypes (usually m1, m2, m3....) that are characterized by their cellular actions, pharmacology, and molecular biology.Receptors, Nicotinic
one of the two major classes of cholinergic receptors. nicotinic receptors were originally distinguished by their preference for nicotine over muscarine. they are generally divided into muscle-type and neuronal-type (previously ganglionic) based on pharmacology, and subunit composition of the receptors.Vesicular Acetylcholine Transport Proteins
vesicular amine transporter proteins that transport the neurotransmitter acetylcholine into small secretory vesicles. proteins of this family contain 12 transmembrane domains and exchange vesicular protons for cytoplasmic acetylcholine.Arecoline
an alkaloid obtained from the betel nut (areca catechu), fruit of a palm tree. it is an agonist at both muscarinic and nicotinic acetylcholine receptors. it is used in the form of various salts as a ganglionic stimulant, a parasympathomimetic, and a vermifuge, especially in veterinary practice. it has been used as a euphoriant in the pacific islands.Bethanechol
a slowly hydrolyzing muscarinic agonist with no nicotinic effects. bethanechol is generally used to increase smooth muscle tone, as in the gi tract following abdominal surgery or in urinary retention in the absence of obstruction. it may cause hypotension, heart rate changes, and bronchial spasm.Bethanechol Compounds
quaternary ammonium compounds that include bethanechol.Carbachol
a slowly hydrolyzed cholinergic agonist that acts at both muscarinic receptors and nicotinic receptors.Pilocarpine
a slowly hydrolyzed muscarinic agonist with no nicotinic effects. pilocarpine is used as a miotic and in the treatment of glaucoma.
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 drugs primarily affecting the autonomic nervous system (T44). 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)
T44.1X6D 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 |
Table of Drugs and Chemicals
The parent code T44.1X6 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 |
---|---|---|---|---|---|---|
Aceclidine | T44.1X1 | T44.1X2 | T44.1X3 | T44.1X4 | T44.1X5 | T44.1X6 |
Acetylcholine | T44.1X1 | T44.1X2 | T44.1X3 | T44.1X4 | T44.1X5 | T44.1X6 |
Acetylcholine »chloride | T44.1X1 | T44.1X2 | T44.1X3 | T44.1X4 | T44.1X5 | T44.1X6 |
Acetylcholine »derivative | T44.1X1 | T44.1X2 | T44.1X3 | T44.1X4 | T44.1X5 | T44.1X6 |
Arecoline | T44.1X1 | T44.1X2 | T44.1X3 | T44.1X4 | T44.1X5 | T44.1X6 |
Benzpyrinium bromide | T44.1X1 | T44.1X2 | T44.1X3 | T44.1X4 | T44.1X5 | T44.1X6 |
Bethanechol | T44.1X1 | T44.1X2 | T44.1X3 | T44.1X4 | T44.1X5 | T44.1X6 |
Bethanechol »chloride | T44.1X1 | T44.1X2 | T44.1X3 | T44.1X4 | T44.1X5 | T44.1X6 |
Carbachol | T44.1X1 | T44.1X2 | T44.1X3 | T44.1X4 | T44.1X5 | T44.1X6 |
Carbamylcholine chloride | T44.1X1 | T44.1X2 | T44.1X3 | T44.1X4 | T44.1X5 | T44.1X6 |
Cholinergic (drug) NEC | T44.1X1 | T44.1X2 | T44.1X3 | T44.1X4 | T44.1X5 | T44.1X6 |
Cholinergic (drug) NEC »muscle tone enhancer | T44.1X1 | T44.1X2 | T44.1X3 | T44.1X4 | T44.1X5 | T44.1X6 |
Cholinergic (drug) NEC »organophosphorus | T44.1X1 | T44.1X2 | T44.1X3 | T44.1X4 | T44.1X5 | T44.1X6 |
Cholinergic (drug) NEC »organophosphorus »insecticide | T44.1X1 | T44.1X2 | T44.1X3 | T44.1X4 | T44.1X5 | T44.1X6 |
Cholinergic (drug) NEC »organophosphorus »nerve gas | T44.1X1 | T44.1X2 | T44.1X3 | T44.1X4 | T44.1X5 | T44.1X6 |
Cholinergic (drug) NEC »trimethyl ammonium propanediol | T44.1X1 | T44.1X2 | T44.1X3 | T44.1X4 | T44.1X5 | T44.1X6 |
Methacholine | T44.1X1 | T44.1X2 | T44.1X3 | T44.1X4 | T44.1X5 | T44.1X6 |
Parasympathomimetic drug NEC | T44.1X1 | T44.1X2 | T44.1X3 | T44.1X4 | T44.1X5 | T44.1X6 |
Pilocarpine | T44.1X1 | T44.1X2 | T44.1X3 | T44.1X4 | T44.1X5 | T44.1X6 |
Pilocarpus (jaborandi) extract | T44.1X1 | T44.1X2 | T44.1X3 | T44.1X4 | T44.1X5 | T44.1X6 |
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
[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.