2024 ICD-10-CM Diagnosis Code T48.4X5S

Adverse effect of expectorants, sequela

ICD-10-CM Code:
T48.4X5S
ICD-10 Code for:
Adverse effect of expectorants, 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)

T48.4X5S is a billable diagnosis code used to specify a medical diagnosis of adverse effect of expectorants, 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.

T48.4X5S is a sequela code, includes a 7th character and should be used for complications that arise as a direct result of a condition like adverse effect of expectorants. 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.

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Acetylcysteine adverse reaction
  • Adverse reaction to bromhexine
  • Adverse reaction to expectorant
  • Beractant adverse reaction
  • Carbocisteine adverse reaction
  • Dornase alfa adverse reaction
  • Ipecacuanha adverse reaction
  • Liquorice adverse reaction
  • Mesna adverse reaction
  • Methylcysteine adverse reaction
  • Respiratory surfactant adverse reaction
  • Terpenes adverse reaction
  • Tyloxapol adverse reaction

Clinical Classification

Clinical Information

  • Acetylcysteine

    the n-acetyl derivative of cysteine. it is used as a mucolytic agent to reduce the viscosity of mucous secretions. it has also been shown to have antiviral effects in patients with hiv due to inhibition of viral stimulation by reactive oxygen intermediates.
  • Ambroxol

    a metabolite of bromhexine that stimulates mucociliary action and clears the air passages in the respiratory tract. it is usually administered as the hydrochloride.
  • Bromhexine

    a mucolytic agent used in the treatment of respiratory disorders associated with viscid or excessive mucus. (from martindale, the extra pharmacopoeia, 30th ed, p744)
  • Glycyrrhizic Acid

    a widely used anti-inflammatory agent isolated from the licorice root. it is metabolized to glycyrrhetinic acid, which inhibits 11-beta-hydroxysteroid dehydrogenases and other enzymes involved in the metabolism of corticosteroids. therefore, glycyrrhizic acid, which is the main and sweet component of licorice, has been investigated for its ability to cause hypermineralocorticoidism with sodium retention and potassium loss, edema, increased blood pressure, as well as depression of the renin-angiotensin-aldosterone system.
  • Guaifenesin

    an expectorant that also has some muscle relaxing action. it is used in many cough preparations.

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 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)

T48.4X5S 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 T48.4X5S to ICD-9-CM

  • ICD-9-CM Code: 909.5 - Lte efct advrs efct drug
    Combination Flag - Multiple codes are needed to describe the source diagnosis code. Correct coding should be done based on contextual judgment.
  • ICD-9-CM Code: E945.5 - Adv eff expectorants
    Combination Flag - Multiple codes are needed to describe the source diagnosis code. Correct coding should be done based on contextual judgment.

Table of Drugs and Chemicals

The parent code T48.4X5 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
AcetylcysteineT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
AmbroxolT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
BromhexineT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
CarbocisteineT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
S-Carboxymethyl-cysteineT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Cough mixture (syrup)T48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Cough mixture (syrup)
  »containing opiates
T48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Cough mixture (syrup)
  »expectorants
T48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Deglycyrrhizinized extract of licoriceT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
DomiodolT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
DornaseT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
EprazinoneT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Expectorant NECT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
GlycerylT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Glyceryl
  »gualacolate
T48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Glyceryl
  »nitrate
T48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Glyceryl
  »triacetate (topical)
T48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Glyceryl
  »trinitrate
T48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Glycyrrhiza extractT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Glycyrrhizic acidT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Glycyrrhizinate potassiumT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Guaiacol derivativesT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
GuaifenesinT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
GuaimesalT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
GuaiphenesinT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Hydriodic acidT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
IpecacuanhaT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
LetosteineT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
LiquoriceT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Liquorice
  »extract
T48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
MecysteineT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
MesnaT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Mucolytic drugT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
MucomystT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
OrganidinT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Quillaja extractT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
RespaireT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Senega syrupT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
SobrerolT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Sputum viscosity-lowering drugT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
SteproninT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
SulfogaiacolT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
SuperinoneT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
TenoglicinT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
Terpin (cis) hydrateT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6
TyloxapolT48.4X1T48.4X2T48.4X3T48.4X4T48.4X5T48.4X6

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.