2024 ICD-10-CM Diagnosis Code T48.1X6S

Underdosing of skeletal muscle relaxants [neuromuscular blocking agents], sequela

ICD-10-CM Code:
T48.1X6S
ICD-10 Code for:
Underdosing of skeletal muscle relaxants, 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 agents primarily acting on smooth and skeletal muscles and the respiratory system
        (T48)

T48.1X6S is a billable diagnosis code used to specify a medical diagnosis of underdosing of skeletal muscle relaxants [neuromuscular blocking agents], 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.

T48.1X6S 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 skeletal muscle relaxants [neuromuscular blocking agents]. 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

  • Succinylcholine

    a quaternary skeletal muscle relaxant usually used in the form of its bromide, chloride, or iodide. it is a depolarizing relaxant, acting in about 30 seconds and with a duration of effect averaging three to five minutes. succinylcholine is used in surgical, anesthetic, and other procedures in which a brief period of muscle relaxation is called for.
  • Vecuronium Bromide

    monoquaternary homolog of pancuronium. a non-depolarizing neuromuscular blocking agent with shorter duration of action than pancuronium. its lack of significant cardiovascular effects and lack of dependence on good kidney function for elimination as well as its short duration of action and easy reversibility provide advantages over, or alternatives to, other established neuromuscular blocking agents.

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 agents primarily acting on smooth and skeletal muscles and the respiratory system (T48). 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)

T48.1X6S 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 T48.1X6S to ICD-9-CM

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

Table of Drugs and Chemicals

The parent code T48.1X6 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
Aclatonium napadisilateT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Alcuronium (chloride)T48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Atracurium besilateT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Carbolonium (bromide)T48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Curare, curarineT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
CyclobenzaprineT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Decamethonium (bromide)T48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Dimethyltubocurarinium chlorideT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Fazadinium bromideT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
FlaxedilT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Gallamine (triethiodide)T48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Hexafluorenium bromideT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Hexafluronium (bromide)T48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
HexanuoreniumT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Hexcarbacholine bromideT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
LaudexiumT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Mivacurium chlorideT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Myoneural blocking agentsT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Neuromuscular blocking drugT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Pancuronium (bromide)T48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Relaxant, muscleT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Relaxant, muscle
  »anesthetic
T48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Relaxant, muscle
  »central nervous system
T48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Relaxant, muscle
  »skeletal NEC
T48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Relaxant, muscle
  »smooth NEC
T48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Skeletal muscle relaxantsT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
SuccinylcholineT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Suxamethonium (chloride)T48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Suxethonium (chloride)T48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
TubocurareT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Tubocurarine (chloride)T48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
UrariT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Vecuronium bromideT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
WooraliT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6

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.