2027 ICD-10-CM Diagnosis Code T37.96XAUnderdosing of unspecified systemic anti-infectives and antiparasitics, initial encounter

ICD-10-CM Codes›S00–T88›T36-T50›T37

ICD-10-CM T37.96XA
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

T37.96XA is a billable ICD-10-CM diagnosis code for underdosing of unspecified systemic anti-infectives and antiparasitics, initial encounter. The 7th character A marks it as an initial encounter code, used while the patient is receiving active treatment. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 951. The code is not accepted as a principal diagnosis by the Medicare Code Editor. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Underdosing of drugs and medicaments, initial encounter.

Code Identity

ICD-10-CM Code
T37.96XA
Billable Status
Yes — Valid for Submission
Code Describes
Underdosing of unspecified systemic anti-infectives and antiparasitics, initial encounter
Short Description
Underdosing of unsp systemic anti-infect/parasit, init
Parent Code
Underdosing of unspecified systemic anti-infectives and antiparasitics

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionT36-T50Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances
CategoryT37Poisoning by, adverse effect of and underdosing of other systemic anti-infectives and antiparasitics
This CodeT37.96XAUnderdosing of unspecified systemic anti-infectives and antiparasitics, initial encounter

Code EditsBilling

Medicare Code Editor checks that affect claim validity for T37.96XA.

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.

Coding GuidelinesGuidance

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 other systemic anti-infectives and antiparasitics (T37). Use the following options for the applicable episode of care:

  • A - initial encounter
  • D - subsequent encounter
  • S - sequela

Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, published by CMS and the National Center for Health Statistics.

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to T37.96XA: its own notes plus those printed at T37, block T36-T50, and Chapter 19. A note printed at a category, block or chapter applies to every code under it.

Includes

Further defines, or gives examples of, the content of the category.

From Block T36-T50 Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances applies to 3,186 codes
  • adverse effect of correct substance properly administered
  • poisoning by overdose of substance
  • poisoning by wrong substance given or taken in error
  • underdosing by (inadvertently) (deliberately) taking less substance than prescribed or instructed

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From T37 Poisoning by, adverse effect of and underdosing of other systemic anti-infectives and antiparasitics applies to 144 codes
  • anti-infectives topically used for ear, nose and throat (T49.6-)
  • anti-infectives topically used for eye (T49.5-)
  • locally applied anti-infectives NEC (T49.0-)
From Block T36-T50 Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances applies to 3,186 codes
  • toxic reaction to local anesthesia in pregnancy (O29.3-)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Block T36-T50 Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances applies to 3,186 codes
  • abuse and dependence of psychoactive substances (F10-F19)
  • abuse of non-dependence-producing substances (F55.-)
  • immunodeficiency due to drugs (D84.821)
  • drug reaction and poisoning affecting newborn (P00-P96)
  • pathological drug intoxication (inebriation) (F10-F19)
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes

Code First

The underlying condition named in the note is sequenced before this code.

From Block T36-T50 Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances applies to 3,186 codes
  • for adverse effects, the nature of the adverse effect, such as:
  • adverse effect NOS (T88.7)
  • aspirin gastritis (K29.-)
  • blood disorders (D56-D76)
  • contact dermatitis (L23-L25)
  • dermatitis due to substances taken internally (L27.-)
  • nephropathy (N14.0-N14.2)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From Block T36-T50 Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances applies to 3,186 codes
  • code(s) to specify:
  • manifestations of poisoning
  • underdosing or failure in dosage during medical and surgical care (Y63.6, Y63.8-Y63.9)
  • underdosing of medication regimen (Z91.12-, Z91.13-)
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • code to identify any retained foreign body, if applicable (Z18.-)

Notes

General instructions on how these codes are used.

From Block T36-T50 Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances applies to 3,186 codes
  • The drug giving rise to the adverse effect should be identified by use of codes from categories T36-T50 with fifth or sixth character 5.
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
  • The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.

7th Character

Every code in the category takes a 7th character from the listed values, with the placeholder X filling any empty positions before it.

From T37 Poisoning by, adverse effect of and underdosing of other systemic anti-infectives and antiparasitics applies to 144 codes
  • The appropriate 7th character is to be added to each code from category T37
  • Ainitial encounter this code
  • Dsubsequent encounter
  • Ssequela

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR INJ029
Underdosing of drugs and medicaments, initial encounter
Default principal diagnosis: inpatient No · outpatient No

Table of Drugs and ChemicalsClinical

Substances in the Table of Drugs and Chemicals that reference this code family. Always confirm in the Tabular List before coding.

SubstanceAccidentalSelf-harmAssaultUndeter­minedAdverse
Effect
Under­dosing
AcriflavineT37.91T37.92T37.93T37.94T37.95T37.96
Ammonium::mandelateT37.91T37.92T37.93T37.94T37.95T37.96
Antifungal::anti-infective NECT37.91T37.92T37.93T37.94T37.95T37.96
Anti-infective NECT37.91T37.92T37.93T37.94T37.95T37.96
Anti-infective NEC::mixedT37.91T37.92T37.93T37.94T37.95T37.96
Antiparasitic drug (systemic)T37.91T37.92T37.93T37.94T37.95T37.96
Calcium::mandelateT37.91T37.92T37.93T37.94T37.95T37.96
EthoxazeneT37.91T37.92T37.93T37.94T37.95T37.96
FuradantinT37.91T37.92T37.93T37.94T37.95T37.96
FuroxoneT37.91T37.92T37.93T37.94T37.95T37.96
NifuraldezoneT37.91T37.92T37.93T37.94T37.95T37.96
Serenium (hydrochloride)T37.91T37.92T37.93T37.94T37.95T37.96

Patient EducationClinical

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:

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert T37.96XA to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
No Map There is no ICD-9 equivalent for this code.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About T37.96XAOverview

Is T37.96XA a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report underdosing of unspecified systemic anti-infectives and antiparasitics, initial encounter on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What does the 7th character A in T37.96XA mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for underdosing of unspecified systemic anti-infectives and antiparasitics, such as an emergency visit or first evaluation.

What MS-DRG does T37.96XA group to?

On inpatient claims, underdosing of unspecified systemic anti-infectives and antiparasitics, initial encounter maps to MS-DRG 951 (other Factors Influencing Health Status), which carries a relative weight of 0.5574. Higher weights mean higher Medicare reimbursement.

Can T37.96XA be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because underdosing of unspecified systemic anti-infectives and antiparasitics, initial encounter describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

Can T37.96XA be reported with a code from T49.6?

Not as a rule. The Excludes1 note at T37, which applies to T37.96XA, lists "anti-infectives topically used for ear, nose and throat (T49.6-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).