ICD-10-CM Code T36.3X6D

Underdosing of macrolides, subsequent encounter

Version 2020 Replaced Code Billable Code Unacceptable Principal Diagnosis POA Exempt

Valid for Submission

T36.3X6D is a billable code used to specify a medical diagnosis of underdosing of macrolides, subsequent encounter. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code T36.3X6D 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.

ICD-10:T36.3X6D
Short Description:Underdosing of macrolides, subsequent encounter
Long Description:Underdosing of macrolides, subsequent encounter

Replaced Code

This code was replaced in the 2020 ICD-10 code set with the code(s) listed below. The National Center for Health Statistics (NCHS) has published an update to the ICD-10-CM diagnosis codes which became effective October 1, 2019. This code was replaced for the FY 2020 (October 1, 2019 - September 30, 2020).

  • K59.03 - Drug induced constipation

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 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.

Diagnostic Related Groups

The ICD-10 code T36.3X6D is grouped in the following groups for version MS-DRG V37.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC).
applicable from 10/01/2020 through 09/30/2020.

  • 949 - AFTERCARE WITH CC/MCC
  • 950 - AFTERCARE WITHOUT CC/MCC

Present on Admission (POA)

T36.3X6D 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.

CMS POA Indicator Options and Definitions
POA Indicator CodePOA Reason 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 T36.3X6D to ICD-9

  • - (No Map Flag)

Code Classification

  • Injury, poisoning and certain other consequences of external causes (S00–T98)
    • Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances (T36-T50)
      • Systemic antibiotics (T36)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

Information for Patients


Antibiotics

Antibiotics are powerful medicines that fight bacterial infections. Used properly, antibiotics can save lives. They either kill bacteria or keep them from reproducing. Your body's natural defenses can usually take it from there.

Antibiotics do not fight infections caused by viruses, such as

  • Colds
  • Flu
  • Most coughs and bronchitis
  • Sore throats, unless caused by strep

If a virus is making you sick, taking antibiotics may do more harm than good. Using antibiotics when you don't need them, or not using them properly, can add to antibiotic resistance. This happens when bacteria change and become able to resist the effects of an antibiotic.

When you take antibiotics, follow the directions carefully. It is important to finish your medicine even if you feel better. If you stop treatment too soon, some bacteria may survive and re-infect you. Do not save antibiotics for later or use someone else's prescription.

Centers for Disease Control and Prevention


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