2024 ICD-10-CM Diagnosis Code T38.7X6

Specific Coding Applicable to Underdosing of androgens and anabolic congeners

Non-specific codes like T38.7X6 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10-CM codes with a higher level of specificity when coding for underdosing of androgens and anabolic congeners:

Clinical Information

• Androsterone

  a metabolite of testosterone or androstenedione with a 3-alpha-hydroxyl group and without the double bond. the 3-beta hydroxyl isomer is epiandrosterone.

• Glucuronosyltransferase

  a family of enzymes accepting a wide range of substrates, including phenols, alcohols, amines, and fatty acids. they function as drug-metabolizing enzymes that catalyze the conjugation of udpglucuronic acid to a variety of endogenous and exogenous compounds. ec 2.4.1.17.

• Ethylestrenol

  an anabolic steroid with some progestational activity and little androgenic effect.

• Norethandrolone

  a synthetic hormone with anabolic and androgenic properties and moderate progestational activity.

• Fluoxymesterone

  an anabolic steroid that has been used in the treatment of male hypogonadism, delayed puberty in males, and in the treatment of breast neoplasms in women.

• Mesterolone

  17 beta-hydroxy-1 alpha-methyl-5 alpha-androstan-3-one. a synthetic steroid with anabolic and androgenic activities.

• Methandriol

  a synthetic steroid with anabolic and androgenic properties. (from martindale, the extra pharmacopoeia, 30th ed, p1188)

• Methandrostenolone

  a synthetic steroid with anabolic properties that are more pronounced than its androgenic effects. it has little progestational activity. (from martindale, the extra pharmacopoeia, 30th ed, p1188)

• Methenolone

  a synthetic steroid that has been used for its anabolic action.

• Methyltestosterone

  a synthetic hormone used for androgen replacement therapy and as an hormonal antineoplastic agent (antineoplastic agents, hormonal).

• Nandrolone

  c18 steroid with androgenic and anabolic properties. it is generally prepared from alkyl ethers of estradiol to resemble testosterone but less one carbon at the 19 position.

• Nandrolone Decanoate

  decanoic acid ester of nandrolone that is used as an anabolic agent to prevent or treat wasting syndrome associated with severe chronic illness or hiv infection (hiv wasting syndrome). it may also be used in the treatment of postmenopausal osteoporosis.

• Oxandrolone

  a synthetic hormone with anabolic and androgenic properties.

• Oxymetholone

  a synthetic hormone with anabolic and androgenic properties. it is used mainly in the treatment of anemias. according to the fourth annual report on carcinogens (ntp 85-002), this compound may reasonably be anticipated to be a carcinogen. (from merck index, 11th ed)

• Stanozolol

  a synthetic steroid that has anabolic and androgenic properties. (from martindale, the extra pharmacopoeia, 30th ed, p1194)

• Testolactone

  an antineoplastic agent that is a derivative of progesterone and used to treat advanced breast cancer.

• 17-Hydroxysteroid Dehydrogenases

  a class of enzymes that catalyzes the oxidation of 17-hydroxysteroids to 17-ketosteroids. ec 1.1.-.

• 3-Oxo-5-alpha-Steroid 4-Dehydrogenase

  an enzyme that catalyzes the reduction of testosterone to 5-alpha dihydrotestosterone.

• 5-alpha Reductase Inhibitors

  drugs that inhibit 3-oxo-5-alpha-steroid 4-dehydrogenase. they are commonly used to reduce the production of dihydrotestosterone.

• Clusterin

  a highly conserved heterodimeric glycoprotein that is differentially expressed during many severe physiological disturbance states such as cancer; apoptosis; and various neurological disorders. clusterin is ubiquitously expressed and appears to function as a secreted molecular chaperone.

• Receptors, Androgen

  proteins, generally found in the cytoplasm, that specifically bind androgens and mediate their cellular actions. the complex of the androgen and receptor migrates to the cell nucleus where it induces transcription of specific segments of dna.

• Sex Hormone-Binding Globulin

  a glycoprotein migrating as a beta-globulin. its molecular weight, 52,000 or 95,000-115,000, indicates that it exists as a dimer. the protein binds testosterone, dihydrotestosterone, and estradiol in the plasma. sex hormone-binding protein has the same amino acid sequence as androgen-binding protein. they differ by their sites of synthesis and post-translational oligosaccharide modifications.

• Steroid 16-alpha-Hydroxylase

  a liver microsomal cytochrome p450 enzyme that catalyzes the 16-alpha-hydroxylation of a broad spectrum of steroids, fatty acids, and xenobiotics in the presence of molecular oxygen and nadph-ferrihemoprotein reductase. this enzyme is encoded by a number of genes from several cyp2 subfamilies.

• Testosterone

  a potent androgenic steroid and major product secreted by the leydig cells of the testis. its production is stimulated by luteinizing hormone from the pituitary gland. in turn, testosterone exerts feedback control of the pituitary lh and fsh secretion. depending on the tissues, testosterone can be further converted to dihydrotestosterone or estradiol.

• Testosterone Congeners

  steroidal compounds related to testosterone, the major mammalian male sex hormone. testosterone congeners include important testosterone precursors in the biosynthetic pathways, metabolites, derivatives, and synthetic steroids with androgenic activities.

• Testosterone Propionate

  an ester of testosterone with a propionate substitution at the 17-beta position.

• Zeranol

  a non-steroidal estrogen analog.

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 hormones and their synthetic substitutes and antagonists, not elsewhere classified (T38). Use the following options for the aplicable episode of care:

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

Table of Drugs and Chemicals

The 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.

Patient Education

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:

• Knowing your medicines. When you get a prescription, ask the name of the medicine and check to make sure that the pharmacy gave you the right medicine. Make sure that you understand how often you should take the medicine and how long you should take it.
• Keeping a list of medicines.
• Write down all of the medicines that you are taking, including the names of your medicines, how much you take, and when you take them. Make sure to include any over-the-counter medicines, vitamins, supplements, and herbs that you take.
• List the medicines that you are allergic to or that have caused you problems in the past.
• Take this list with you every time you see a health care provider.
• Reading medicine labels and following the directions. Don't just rely on your memory - read the medication label every time. Be especially careful when giving medicines to children.
• Asking questions. If you don't know the answers to these questions, ask your health care provider or pharmacist:
• Why am I taking this medicine?
• What are the common side effects?
• What should I do if I have side effects?
• When should I stop this medicine?
• Can I take this medicine with the other medicines and supplements on my list?
• Do I need to avoid certain foods or alcohol while taking this medicine?

Food and Drug Administration

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.