Valid for Submission
T36.96XS is a billable diagnosis code used to specify a medical diagnosis of underdosing of unspecified systemic antibiotic, sequela. The code T36.96XS is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 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 T36.96XS 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.
T36.96XS is a sequela code, includes a 7th character and should be used for complications that arise as a direct result of a condition like underdosing of unspecified systemic antibiotic. 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.
Unspecified diagnosis codes like T36.96XS are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.
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:
Diagnostic Related Groups - MS-DRG Mapping
Present on Admission (POA)
Convert T36.96XS to ICD-9 Code
Information for Patients
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
- 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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