2024 ICD-10-CM Diagnosis Code T36.0X5D

Adverse effect of penicillins, subsequent encounter

ICD-10-CM Code:
T36.0X5D
ICD-10 Code for:
Adverse effect of penicillins, subsequent encounter
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 systemic antibiotics
        (T36)

T36.0X5D is a billable diagnosis code used to specify a medical diagnosis of adverse effect of penicillins, 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.

T36.0X5D is a subsequent encounter code, includes a 7th character and should be used after the patient has completed active treatment for a condition like adverse effect of penicillins. 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.

Approximate Synonyms

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

  • Adverse reaction to amoxicillin and/or clavulanic acid
  • Adverse reaction to amoxicillin and/or clavulanic acid
  • Adverse reaction to ampicillin and/or cloxacillin
  • Adverse reaction to ampicillin and/or cloxacillin
  • Adverse reaction to ampicillin and/or floxacillin
  • Adverse reaction to ampicillin and/or floxacillin
  • Adverse reaction to clavulanic acid and/or ticarcillin
  • Adverse reaction to clavulanic acid and/or ticarcillin
  • Adverse reaction to piperacillin and/or tazobactam
  • Adverse reaction to piperacillin and/or tazobactam
  • Adverse reaction to pivampicillin and/or pivmecillinam
  • Allergic reaction caused by penicillin
  • Allergic reaction caused by penicillin
  • Amoxycillin adverse reaction
  • Ampicillin adverse reaction
  • Ampicillin adverse reaction
  • Antipseudomonal penicillins adverse reaction
  • Azlocillin adverse reaction
  • Bacampicillin adverse reaction
  • Benethamine penicillin adverse reaction
  • Benzathine penicillin adverse reaction
  • Benzylpenicillin adverse reaction
  • Broad spectrum penicillins adverse reaction
  • Broad spectrum penicillins adverse reaction
  • Carbenicillin adverse reaction
  • Carfecillin adverse reaction
  • Ciclacillin adverse reaction
  • Cloxacillin adverse reaction
  • Epstein-Barr virus infectious mononucleosis
  • Flucloxacillin adverse reaction
  • Infectious mononucleosis ampicillin reaction
  • Infectious mononucleosis exanthem
  • Maculopapular drug eruption
  • Maculopapular eruption
  • Mecillinam adverse reaction
  • Methicillin adverse reaction
  • Mezlocillin adverse reaction
  • Penicillin adverse reaction
  • Penicillinase-resistant penicillins adverse reaction
  • Penicillinase-sensitive penicillins adverse reaction
  • Penicillin-induced anaphylaxis
  • Penicillin-induced angioedema-urticaria
  • Phenethicillin adverse reaction
  • Phenoxymethylpenicillin adverse reaction
  • Piperacillin adverse reaction
  • Pivampicillin adverse reaction
  • Pivmecillinam adverse reaction
  • Procaine benzylpenicillin adverse reaction
  • Talampicillin adverse reaction
  • Temocillin adverse reaction
  • Ticarcillin adverse reaction

Clinical Classification

Clinical Information

  • Amoxicillin

    a broad-spectrum semisynthetic antibiotic similar to ampicillin except that its resistance to gastric acid permits higher serum levels with oral administration.
  • Amoxicillin-Potassium Clavulanate Combination

    a fixed-ratio combination of amoxicillin trihydrate and potassium clavulanate.
  • Ampicillin

    semi-synthetic derivative of penicillin that functions as an orally active broad-spectrum antibiotic.
  • Ampicillin Resistance

    nonsusceptibility of a microbe to the action of ampicillin, a penicillin derivative that interferes with cell wall synthesis.
  • Pivampicillin

    pivalate ester analog of ampicillin.
  • Talampicillin

    an ester of ampicillin which is readily hydrolyzed on absorption to release ampicillin. it is well absorbed from the gastrointestinal tract resulting in a greater bioavailability of ampicillin than can be achieved with equivalent doses of ampicillin.
  • Azlocillin

    a semisynthetic ampicillin-derived acylureido penicillin.
  • Carbenicillin

    broad-spectrum semisynthetic penicillin derivative used parenterally. it is susceptible to gastric juice and penicillinase and may damage platelet function.
  • Carfecillin

    the phenyl ester of carbenicillin that, upon oral administration, is broken down in the intestinal mucosa to the active antibacterial. it is used for urinary tract infections.
  • Penicillinase

    a beta-lactamase preferentially cleaving penicillins. (dorland, 28th ed) ec 3.5.2.-.
  • Cloxacillin

    a semi-synthetic antibiotic that is a chlorinated derivative of oxacillin.
  • Cyclacillin

    a cyclohexylamido analog of penicillanic acid.
  • Dicloxacillin

    one of the penicillins which is resistant to penicillinase.
  • Cilastatin, Imipenem Drug Combination

    combination of imipenem and cilastatin that is used in the treatment of bacterial infections; cilastatin inhibits renal dehydropeptidase i to prolong the half-life and increase the tissue penetration of imipenem, enhancing its efficacy as an anti-bacterial agent.
  • Imipenem

    semisynthetic thienamycin that has a wide spectrum of antibacterial activity against gram-negative and gram-positive aerobic and anaerobic bacteria, including many multiresistant strains. it is stable to beta-lactamases. clinical studies have demonstrated high efficacy in the treatment of infections of various body systems. its effectiveness is enhanced when it is administered in combination with cilastatin, a renal dipeptidase inhibitor.
  • Methicillin

    one of the penicillins which is resistant to penicillinase but susceptible to a penicillin-binding protein. it is inactivated by gastric acid so administered by injection.
  • Methicillin Resistance

    non-susceptibility of a microbe to the action of methicillin, a semi-synthetic penicillin derivative.
  • Methicillin-Resistant Staphylococcus aureus

    a strain of staphylococcus aureus that is non-susceptible to the action of methicillin. the mechanism of resistance usually involves modification of normal or the presence of acquired penicillin binding proteins.
  • Mezlocillin

    semisynthetic ampicillin-derived acylureido penicillin. it has been proposed for infections with certain anaerobes and may be useful in inner ear, bile, and cns infections.
  • Nafcillin

    a semi-synthetic antibiotic related to penicillin.
  • Oxacillin

    an antibiotic similar to flucloxacillin used in resistant staphylococci infections.
  • Piperacillin

    semisynthetic, broad-spectrum, ampicillin derived ureidopenicillin antibiotic proposed for pseudomonas infections. it is also used in combination with other antibiotics.
  • Piperacillin, Tazobactam Drug Combination

    an antibiotic combination product of piperacillin and tazobactam, a penicillanic acid derivative with enhanced beta-lactamase inhibitory activity, that is used for the intravenous treatment of intra-abdominal, pelvic, and skin infections and for community-acquired pneumonia of moderate severity. it is also used for the treatment of pseudomonas aeruginosa infections.
  • Sulbactam

    a beta-lactamase inhibitor with very weak antibacterial action. the compound prevents antibiotic destruction of beta-lactam antibiotics by inhibiting beta-lactamases, thus extending their spectrum activity. combinations of sulbactam with beta-lactam antibiotics have been used successfully for the therapy of infections caused by organisms resistant to the antibiotic alone.
  • Sulbenicillin

    semisynthetic penicillin-type antibiotic.
  • Ticarcillin

    an antibiotic derived from penicillin similar to carbenicillin in action.

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 systemic antibiotics (T36). 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)

T36.0X5D 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 T36.0X5D to ICD-9-CM

  • ICD-9-CM Code: V58.89 - Other specfied aftercare
    Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Table of Drugs and Chemicals

The parent code T36.0X5 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
AdicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
AmdinocillineT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
AmoxicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
AmpicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
AncillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
ApalcillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
AspoxicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
AzidocillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
AzlocillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
BacampicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
Benethamine penicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
Benzathine benzylpenicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
Benzathine penicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
BenzylpenicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
CarbenicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
CarfecillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
CarindacillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
CiclacillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
ClometocillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
CloxacillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
CyclacillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
DicloxacillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
EpicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
FlucloxacillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
HetacillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
Hydrabamine penicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
ImipenemT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
Isoxazolyl penicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
MecillinamT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
MetampicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
MethicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
Methoxybenzyl penicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
MeticillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
MezlocillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
NafcillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
OxacillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
PenamecillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
PenethamateT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
Penicillin (any)T36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
PhenbenicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
PheneticillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
Phenoxymethyl penicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
PhenthicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
PiperacillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
PivampicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
PivmecillinamT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
PropicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
SulbactamT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
SulbenicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
SultamicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
TalampicillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
TemocillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
TicarcillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6
XantocillinT36.0X1T36.0X2T36.0X3T36.0X4T36.0X5T36.0X6

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.