2024 ICD-10-CM Diagnosis Code T48.5X6A

Underdosing of other anti-common-cold drugs, initial encounter

ICD-10-CM Code:
T48.5X6A
ICD-10 Code for:
Underdosing of other anti-common-cold drugs, init encntr
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)

T48.5X6A is a billable diagnosis code used to specify a medical diagnosis of underdosing of other anti-common-cold drugs, initial 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.

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.

T48.5X6A is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like underdosing of other anti-common-cold drugs. According to ICD-10-CM Guidelines an "initial encounter" doesn't necessarily means "initial visit". The 7th character should be used when the patient is undergoing active treatment regardless if new or different providers saw the patient over the course of a treatment. The appropriate 7th character codes should also be used even if the patient delayed seeking treatment for a condition.

Clinical Classification

Clinical Information

  • Menthol

    a monoterpene cyclohexanol produced from mint oils.
  • Naphazoline

    an adrenergic vasoconstrictor agent used as a decongestant.
  • Oxymetazoline

    a direct acting sympathomimetic used as a vasoconstrictor to relieve nasal congestion. (from martindale, the extra pharmacopoeia, 30th ed, p1251)

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.

Convert T48.5X6A to ICD-9-CM

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

Table of Drugs and Chemicals

The parent code T48.5X6 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
Amidefrine mesilateT48.5X1T48.5X2T48.5X3T48.5X4T48.5X5T48.5X6
Anti-common-cold drug NECT48.5X1T48.5X2T48.5X3T48.5X4T48.5X5T48.5X6
APCT48.5X1T48.5X2T48.5X3T48.5X4T48.5X5T48.5X6
Benzoin (tincture)T48.5X1T48.5X2T48.5X3T48.5X4T48.5X5T48.5X6
CinnamedrineT48.5X1T48.5X2T48.5X3T48.5X4T48.5X5T48.5X6
ContacT48.5X1T48.5X2T48.5X3T48.5X4T48.5X5T48.5X6
Decongestant, nasal (mucosa)T48.5X1T48.5X2T48.5X3T48.5X4T48.5X5T48.5X6
Decongestant, nasal (mucosa)
  »combination
T48.5X1T48.5X2T48.5X3T48.5X4T48.5X5T48.5X6
FenoxazolineT48.5X1T48.5X2T48.5X3T48.5X4T48.5X5T48.5X6
IndanazolineT48.5X1T48.5X2T48.5X3T48.5X4T48.5X5T48.5X6
MentholT48.5X1T48.5X2T48.5X3T48.5X4T48.5X5T48.5X6
MetizolineT48.5X1T48.5X2T48.5X3T48.5X4T48.5X5T48.5X6
NaphazolineT48.5X1T48.5X2T48.5X3T48.5X4T48.5X5T48.5X6
OxymetazolineT48.5X1T48.5X2T48.5X3T48.5X4T48.5X5T48.5X6
PropylhexedrineT48.5X1T48.5X2T48.5X3T48.5X4T48.5X5T48.5X6
TramazolineT48.5X1T48.5X2T48.5X3T48.5X4T48.5X5T48.5X6
TuaminoheptaneT48.5X1T48.5X2T48.5X3T48.5X4T48.5X5T48.5X6
TymazolineT48.5X1T48.5X2T48.5X3T48.5X4T48.5X5T48.5X6
XylometazolineT48.5X1T48.5X2T48.5X3T48.5X4T48.5X5T48.5X6

Patient Education


Cold and Cough Medicines

What are cold and cough medicines?

Cold and cough medicines can help relieve symptoms of a common cold. The symptoms of a cold can include a sore throat, stuffy or runny nose, sneezing, and coughing.

You don't usually need to treat a cold or the cough that it causes. You can't cure a cold, and antibiotics won't help you get better. But sometimes the symptoms can keep you awake or cause a lot of discomfort. In that case, cold and cough medicines can sometimes be helpful.

What are the different types of cold and cough medicines?

There are lots of different cold and cough medicines, and they do different things:

  • Nasal decongestants - unclog a stuffy nose
  • Cough suppressants - quiet a cough
  • Expectorants - loosen mucus in your lungs so you can cough it up
  • Antihistamines - stop runny noses and sneezing
  • Pain relievers - ease fever, headaches, and minor aches and pains

What do I need to know about taking cold and cough medicines?

Before taking these medicines, read the labels and follow the instructions carefully. Many cold and cough medicines contain the same active ingredients. For example, some of them include pain relievers. If you are taking these medicines and are also taking a separate pain reliever, you could be getting a dangerous amount of the pain reliever.

Do not give cold or cough medicines to children under two, and don't give aspirin to children.

What else can I do to feel better for a cold or cough?

If you decide that you don't want to take cold and cough medicines, there are other ways to feel better:

  • Drink lots of fluids
  • Get plenty of rest
  • Use a cool mist humidifier
  • Use saline nose drops or sprays
  • Use nasal suctioning with a bulb syringe, which can be very helpful in children under a year old

Centers for Disease Control and Prevention


[Learn More in MedlinePlus]

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.