2024 ICD-10-CM Diagnosis Code T36.3X6A

Underdosing of macrolides, initial encounter

ICD-10-CM Code:
T36.3X6A
ICD-10 Code for:
Underdosing of macrolides, initial 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)

T36.3X6A is a billable diagnosis code used to specify a medical diagnosis of underdosing of macrolides, 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.

T36.3X6A 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 macrolides. 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

  • Azithromycin

    a semi-synthetic macrolide antibiotic structurally related to erythromycin. it has been used in the treatment of mycobacterium avium intracellulare infections, toxoplasmosis, and cryptosporidiosis.
  • Josamycin

    a macrolide antibiotic from streptomyces narbonensis. the drug has antimicrobial activity against a wide spectrum of pathogens.
  • Kitasamycin

    a macrolide antibiotic produced by streptomyces kitasatoensis. the drug has antimicrobial activity against a wide spectrum of pathogens.
  • Oleandomycin

    antibiotic macrolide produced by streptomyces antibioticus.
  • Pristinamycin

    an antibiotic mixture originally isolated from streptomyces pristinaspiralis. it is a mixture of compounds from streptogramin group a: pristinamycin iia and iib and from streptogramin group b: pristinamycin ia, pristinamycin ib, pristinamycin ic.
  • Streptogramin A

    a specific streptogramin group a antibiotic produced by streptomyces graminofaciens and other bacteria.
  • Streptogramin B

    a specific streptogramin group b antibiotic produced by streptomyces graminofaciens and other bacteria.
  • Roxithromycin

    semisynthetic derivative of erythromycin. it is concentrated by human phagocytes and is bioactive intracellularly. while the drug is active against a wide spectrum of pathogens, it is particularly effective in the treatment of respiratory and genital tract infections.
  • Spiramycin

    a macrolide antibiotic produced by streptomyces ambofaciens. the drug is effective against gram-positive aerobic pathogens, n. gonorrhoeae, and staphylococci. it is used to treat infections caused by bacteria and toxoplasma gondii.
  • Troleandomycin

    a macrolide antibiotic that is similar to erythromycin.

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 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.

Convert T36.3X6A to ICD-9-CM

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

Table of Drugs and Chemicals

The parent code T36.3X6 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
AzithromycinT36.3X1T36.3X2T36.3X3T36.3X4T36.3X5T36.3X6
Erythromycin (salts)T36.3X1T36.3X2T36.3X3T36.3X4T36.3X5T36.3X6
Erythromycin (salts)
  »ophthalmic preparation
T36.3X1T36.3X2T36.3X3T36.3X4T36.3X5T36.3X6
Erythromycin (salts)
  »topical NEC
T36.3X1T36.3X2T36.3X3T36.3X4T36.3X5T36.3X6
IlotycinT36.3X1T36.3X2T36.3X3T36.3X4T36.3X5T36.3X6
Ilotycin
  »ophthalmic preparation
T36.3X1T36.3X2T36.3X3T36.3X4T36.3X5T36.3X6
Ilotycin
  »topical NEC
T36.3X1T36.3X2T36.3X3T36.3X4T36.3X5T36.3X6
JosamycinT36.3X1T36.3X2T36.3X3T36.3X4T36.3X5T36.3X6
KitasamycinT36.3X1T36.3X2T36.3X3T36.3X4T36.3X5T36.3X6
MidecamycinT36.3X1T36.3X2T36.3X3T36.3X4T36.3X5T36.3X6
MiokamycinT36.3X1T36.3X2T36.3X3T36.3X4T36.3X5T36.3X6
OleandomycinT36.3X1T36.3X2T36.3X3T36.3X4T36.3X5T36.3X6
PristinamycinT36.3X1T36.3X2T36.3X3T36.3X4T36.3X5T36.3X6
RokitamycinT36.3X1T36.3X2T36.3X3T36.3X4T36.3X5T36.3X6
RoxithromycinT36.3X1T36.3X2T36.3X3T36.3X4T36.3X5T36.3X6
SpiramycinT36.3X1T36.3X2T36.3X3T36.3X4T36.3X5T36.3X6
TAOT36.3X1T36.3X2T36.3X3T36.3X4T36.3X5T36.3X6
TriacetyloleandomycinT36.3X1T36.3X2T36.3X3T36.3X4T36.3X5T36.3X6
TroleandomycinT36.3X1T36.3X2T36.3X3T36.3X4T36.3X5T36.3X6

Patient Education


Antibiotics

What are antibiotics?

Antibiotics are medicines that fight bacterial infections in people and animals. They work by killing the bacteria or by making it hard for the bacteria to grow and multiply.

Antibiotics can be taken in different ways:

  • Orally (by mouth). This could be pills, capsules, or liquids.
  • Topically. This might be a cream, spray, or ointment that you put on your skin. It could also be eye ointment, eye drops, or ear drops.
  • Through an injection or intravenously (IV). This is usually for more serious infections.

What do antibiotics treat?

Antibiotics only treat certain bacterial infections, such as strep throat, urinary tract infections, and E. coli.

You may not need to take antibiotics for some bacterial infections. For example, you might not need them for many sinus infections or some ear infections. Taking antibiotics when they're not needed won't help you, and they can have side effects. Your health care provider can decide the best treatment for you when you're sick. Don't ask your provider to prescribe an antibiotic for you.

Do antibiotics treat viral infections?

Antibiotics do not work on viral infections. For example, you shouldn't take antibiotics for:

  • Colds and runny noses, even if the mucus is thick, yellow, or green
  • Most sore throats (except strep throat)
  • Flu
  • Most cases of bronchitis

What are the side effects of antibiotics?

The side effects of antibiotics range from minor to very severe. Some of the common side effects include:

  • Rash
  • Nausea
  • Diarrhea
  • Yeast infections

More serious side effects can include:

  • C. diff infections, which cause diarrhea that can lead to severe colon damage and sometimes even death
  • Severe and life-threatening allergic reactions
  • Antibiotic resistance infections

Call your health care provider if you develop any side effects while taking your antibiotic.

Why is it important to take antibiotics only when they're needed?

You should only take antibiotics when they are needed because they can cause side effects and can contribute to antibiotic resistance. Antibiotic resistance happens when the bacteria change and become able to resist the effects of an antibiotic. This means that the bacteria continue to grow.

How do I use antibiotics correctly?

When you take antibiotics, it is important that you take them responsibly:

  • Always follow the directions carefully. Finish your medicine even if you feel better. If you stop taking them too soon, some bacteria may survive and re-infect you.
  • Don't save your antibiotics for later.
  • Don't share your antibiotic with others.
  • Don't take antibiotics prescribed for someone else. This may delay the best treatment for you, make you even sicker, or cause side effects.

Centers for Disease Control and Prevention


[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.