2024 ICD-10-CM Diagnosis Code T38.895A
Adverse effect of other hormones and synthetic substitutes, initial encounter
- ICD-10-CM Code:
- T38.895A
- ICD-10 Code for:
- Adverse effect of hormones and synthetic substitutes, init
- Is Billable?
- Yes - Valid for Submission
- Chronic Condition Indicator: [1]
- Not chronic
- Code Navigator:
T38.895A is a billable diagnosis code used to specify a medical diagnosis of adverse effect of other hormones and synthetic substitutes, 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.
T38.895A is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like adverse effect of other hormones and synthetic substitutes. 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.
Approximate Synonyms
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Adverse reaction caused by antidiuretic hormone
- Adverse reaction to hypothalamic hormone
- Adverse reaction to posterior pituitary hormones
- Buserelin adverse reaction
- Calcium regulating hormone adverse reaction
- Cyclofenil adverse reaction
- Desmopressin adverse reaction
- Gonad regulating hormone adverse reaction
- Gonadorelin adverse reaction
- Gonadotrophic hormone adverse reaction
- Hemostatic adverse reaction
- Lypressin adverse reaction
- Nafarelin adverse reaction
- Protirelin adverse reaction
- Sex hormones adverse reaction
- Terlipressin adverse reaction
- Thyrotropin releasing factor adverse reaction
- Vasopressor adverse reaction
Clinical Classification
Clinical Category is Adverse effects of drugs and medicaments, initial encounter
- CCSR Category Code: INJ028
- Inpatient Default CCSR: X - Not applicable.
- Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Clinical Information
Buserelin
a potent synthetic analog of gonadotropin-releasing hormone with d-serine substitution at residue 6, glycine10 deletion, and other modifications.Chorionic Gonadotropin
a gonadotropic glycoprotein hormone produced primarily by the placenta. similar to the pituitary luteinizing hormone in structure and function, chorionic gonadotropin is involved in maintaining the corpus luteum during pregnancy. cg consists of two noncovalently linked subunits, alpha and beta. within a species, the alpha subunit is virtually identical to the alpha subunits of the three pituitary glycoprotein hormones (tsh, lh, and fsh), but the beta subunit is unique and confers its biological specificity (chorionic gonadotropin, beta subunit, human).Chorionic Gonadotropin, beta Subunit, Human
the beta subunit of human chorionic gonadotropin. its structure is similar to the beta subunit of luteinizing hormone, except for the additional 30 amino acids at the carboxy end with the associated carbohydrate residues. hcg-beta is used as a diagnostic marker for early detection of pregnancy, spontaneous abortion (abortion, spontaneous); ectopic pregnancy; hydatidiform mole; choriocarcinoma; or down syndrome.Glycoprotein Hormones, alpha Subunit
the alpha chain of pituitary glycoprotein hormones (thyrotropin; follicle stimulating hormone; luteinizing hormone) and the placental chorionic gonadotropin. within a species, the alpha subunits of these four hormones are identical; the distinct functional characteristics of these glycoprotein hormones are determined by the unique beta subunits. both subunits, the non-covalently bound heterodimers, are required for full biologic activity.Receptors, LH
those protein complexes or molecular sites on the surfaces and cytoplasm of gonadal cells that bind luteinizing or chorionic gonadotropic hormones and thereby cause the gonadal cells to synthesize and secrete sex steroids. the hormone-receptor complex is internalized from the plasma membrane and initiates steroid synthesis.Felypressin
a synthetic analog of lypressin with a phenylalanine substitution at residue 2. felypressin is a vasoconstrictor with reduced antidiuretic activity.Leuprolide
a potent synthetic long-acting agonist of gonadotropin-releasing hormone that regulates the synthesis and release of pituitary gonadotropins, luteinizing hormone and follicle stimulating hormone.Lypressin
the porcine antidiuretic hormone (vasopressins). it is a cyclic nonapeptide that differs from arg-vasopressin by one amino acid, containing a lysine at residue 8 instead of an arginine. lys-vasopressin is used to treat diabetes insipidus or to improve vasomotor tone and blood pressure.Sermorelin
the biologically active fragment of human growth hormone-releasing factor, consisting of ghrh(1-29)-amide. this n-terminal sequence is identical in several mammalian species, such as human, pig, and cattle. it is used to diagnose or treat patients with growth hormone deficiency.Terlipressin
an inactive peptide prodrug that is slowly converted in the body to lypressin. it is used to control bleeding of esophageal varices and for the treatment of hepatorenal syndrome.
Coding Guidelines
When coding an adverse effect of a drug that has been correctly prescribed and properly administered, assign the appropriate code for the nature of the adverse effect followed by the appropriate code for the adverse effect of the drug.
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
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 T38.895A to ICD-9-CM
- ICD-9-CM Code: 995.29 - Adv eff med/biol NEC/NOS
Combination Flag - Multiple codes are needed to describe the source diagnosis code. Correct coding should be done based on contextual judgment. - ICD-9-CM Code: E932.9 - Adv eff hormones NEC/NOS
Combination Flag - Multiple codes are needed to describe the source diagnosis code. Correct coding should be done based on contextual judgment.
Table of Drugs and Chemicals
The parent code T38.895 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.
Patient Education
Drug Reactions
Most of the time, medicines make our lives better. They reduce aches and pains, fight infections, and control problems such as high blood pressure or diabetes. But medicines can also cause unwanted reactions, such as drug interactions, side effects, and allergies.
What is a drug interaction?
A drug interaction is a change in the way a drug acts in the body when taken with certain other drugs, foods, or supplements or when taken while you have certain medical conditions. Examples include:
- Two drugs, such as aspirin and blood thinners
- Drugs and food, such as statins and grapefruit
- Drugs and supplements, such as gingko and blood thinners
- Drugs and medical conditions, such as aspirin and peptic ulcers
Interactions could cause a drug to be more or less effective, cause side effects, or change the way one or both drugs work.
What are side effects?
Side effects are unwanted, usually unpleasant, effects caused by medicines. Most are mild, such as a stomachache, dry mouth, or drowsiness, and go away after you stop taking the medicine. Others can be more serious. Sometimes a drug can interact with a disease that you have and cause a side effect. For example, if you have a heart condition, certain decongestants can cause you to have a rapid heartbeat.
What are drug allergies?
Drug allergies are another type of reaction. They can range from mild to life-threatening. Skin reactions, such as hives and rashes, are the most common type. Anaphylaxis, a serious allergic reaction, is less common.
How can I stay safe when taking medicines?
When you start a new prescription or over-the-counter medicine, make sure you understand how to take it correctly. Know which other medicines, foods, and supplements you need to avoid. Always talk to your health care provider or pharmacist if you have questions about your medicines.
[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.