2024 ICD-10-CM Diagnosis Code T44.996D

Underdosing of other drug primarily affecting the autonomic nervous system, subsequent encounter

ICD-10-CM Code:
T44.996D
ICD-10 Code for:
Underdosing of drug aff the autonomic nervous system, 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 drugs primarily affecting the autonomic nervous system
        (T44)

T44.996D is a billable diagnosis code used to specify a medical diagnosis of underdosing of other drug primarily affecting the autonomic nervous system, 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.

T44.996D 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 drug primarily affecting the autonomic nervous system. 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 Information

  • Arylsulfotransferase

    a sulfotransferase that catalyzes the sulfation of a phenol in the presence of 3'-phosphoadenylylsulfate as sulfate donor to yield an aryl sulfate and adenosine 3',5'-bisphosphate. a number of aromatic compounds can act as acceptors; however, organic hydroxylamines are not substrates. sulfate conjugation by this enzyme is a major pathway for the biotransformation of phenolic and catechol drugs as well as neurotransmitters. ec 2.8.2.1.
  • Dopamine

    one of the catecholamine neurotransmitters in the brain. it is derived from tyrosine and is the precursor to norepinephrine and epinephrine. dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. a family of receptors (receptors, dopamine) mediate its action.
  • Dopamine Agents

    any drugs that are used for their effects on dopamine receptors, on the life cycle of dopamine, or on the survival of dopaminergic neurons.
  • Dopamine Agonists

    drugs that bind to and activate dopamine receptors.
  • Dopamine and cAMP-Regulated Phosphoprotein 32

    a phosphoprotein that was initially identified as a major target of dopamine activated adenylyl cyclase in the corpus striatum. it regulates the activities of protein phosphatase-1 and protein kinase a, and it is a key mediator of the biochemical, electrophysiological, transcriptional, and behavioral effects of dopamine.
  • Dopamine Antagonists

    drugs that bind to but do not activate dopamine receptors, thereby blocking the actions of dopamine or exogenous agonists. many drugs used in the treatment of psychotic disorders (antipsychotic agents) are dopamine antagonists, although their therapeutic effects may be due to long-term adjustments of the brain rather than to the acute effects of blocking dopamine receptors. dopamine antagonists have been used for several other clinical purposes including as antiemetics, in the treatment of tourette syndrome, and for hiccup. dopamine receptor blockade is associated with neuroleptic malignant syndrome.
  • Dopamine beta-Hydroxylase

  • Dopamine D2 Receptor Antagonists

    compounds and drugs that bind to and inhibit or block the activation of dopamine d2 receptors.
  • Dopamine Plasma Membrane Transport Proteins

    sodium chloride-dependent neurotransmitter symporters located primarily on the plasma membrane of dopaminergic neurons. they remove dopamine from the extracellular space by high affinity reuptake into presynaptic terminals and are the target of dopamine uptake inhibitors.
  • Dopamine Uptake Inhibitors

    drugs that block the transport of dopamine into axon terminals or into storage vesicles within terminals. most of the adrenergic uptake inhibitors also inhibit dopamine uptake.
  • Dopaminergic Imaging

    functional brain imaging techniques that utilize various radionuclide tracers that bind to different targets in the synapses of dopaminergic neurons.
  • Dopaminergic Neurons

    neurons whose primary neurotransmitter is dopamine.
  • Receptors, Dopamine

    cell-surface proteins that bind dopamine with high affinity and trigger intracellular changes influencing the behavior of cells.
  • Receptors, Dopamine D1

    a subfamily of g-protein-coupled receptors that bind the neurotransmitter dopamine and modulate its effects. d1-class receptor genes lack introns, and the receptors stimulate adenylyl cyclases.
  • Receptors, Dopamine D2

    a subfamily of g-protein-coupled receptors that bind the neurotransmitter dopamine and modulate its effects. d2-class receptor genes contain introns, and the receptors inhibit adenylyl cyclases.
  • Receptors, Dopamine D3

    a subtype of dopamine d2 receptors that are highly expressed in the limbic system of the brain.
  • Receptors, Dopamine D4

    a subtype of dopamine d2 receptors that has high affinity for the antipsychotic clozapine.
  • Receptors, Dopamine D5

    a subtype of dopamine d1 receptors that has higher affinity for dopamine and differentially couples to gtp-binding proteins.
  • Ephedra

    a plant genus of the family ephedraceae, order ephedrales, class gnetopsida, division gnetophyta.
  • Ephedra sinica

    a plant species of the family ephedraceae, order ephedrales, class gnetopsida, division gnetophyta. it is a source of ephedrine and other alkaloids.
  • Ephedrine

    a phenethylamine found in ephedra sinica. pseudoephedrine is an isomer. it is an alpha- and beta-adrenergic agonist that may also enhance release of norepinephrine. it has been used for asthma, heart failure, rhinitis, and urinary incontinence, and for its central nervous system stimulatory effects in the treatment of narcolepsy and depression. it has become less extensively used with the advent of more selective agonists.
  • Pseudoephedrine

    a phenethylamine that is an isomer of ephedrine which has less central nervous system effects and usage is mainly for respiratory tract decongestion.
  • Mephentermine

    a sympathomimetic agent with specificity for alpha-1 adrenergic receptors. it is used to maintain blood pressure in hypotensive states such as following spinal anesthesia.
  • Phenylpropanolamine

    a sympathomimetic that acts mainly by causing release of norepinephrine but also has direct agonist activity at some adrenergic receptors. it is most commonly used as a nasal vasoconstrictor and an appetite depressant.

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)

T44.996D 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 T44.996D to ICD-9-CM

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

Table of Drugs and Chemicals

The parent code T44.996 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
Amezinium metilsulfateT44.991T44.992T44.993T44.994T44.995T44.996
AngiotensinamideT44.991T44.992T44.993T44.994T44.995T44.996
BenzedrexT44.991T44.992T44.993T44.994T44.995T44.996
DopamineT44.991T44.992T44.993T44.994T44.995T44.996
EphedraT44.991T44.992T44.993T44.994T44.995T44.996
EphedrineT44.991T44.992T44.993T44.994T44.995T44.996
IbopamineT44.991T44.992T44.993T44.994T44.995T44.996
IsoephedrineT44.991T44.992T44.993T44.994T44.995T44.996
MephentermineT44.991T44.992T44.993T44.994T44.995T44.996
PhenylpropanolamineT44.991T44.992T44.993T44.994T44.995T44.996
PseudoephedrineT44.991T44.992T44.993T44.994T44.995T44.996

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.