2026 ICD-10-CM Diagnosis Code T38.895AAdverse effect of other hormones and synthetic substitutes, initial encounter
T38.895A is a billable ICD-10-CM diagnosis code for adverse effect of other hormones and synthetic substitutes, 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 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 917 through 918. 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 Adverse effects of drugs and medicaments, initial encounter.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for T38.895A.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this 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
Coding GuidelinesGuidance
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 applicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2026, published by CMS and the National Center for Health Statistics.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
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.
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.
Patient EducationClinical
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.
The full article covers:
- What is a drug interaction?
- What are side effects?
- What are drug allergies?
- How can I stay safe when taking medicines?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert T38.895A to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About T38.895AOverview
Is T38.895A (Adverse effect of other hormones and synthetic substitutes) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report adverse effect of other hormones and synthetic substitutes, initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character A in T38.895A mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for adverse effect of other hormones and synthetic substitutes, such as an emergency visit or first evaluation.
What MS-DRG does T38.895A group to?
On inpatient claims, adverse effect of other hormones and synthetic substitutes, initial encounter maps to MS-DRG 917, 918, with relative weights from 0.8571 to 1.5684 depending on complications. Higher weights mean higher Medicare reimbursement.
Can T38.895A be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because adverse effect of other hormones and synthetic substitutes, initial encounter describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
What is the ICD-9 equivalent of T38.895A?
Under the General Equivalence Mappings, adverse effect of other hormones and synthetic substitutes, initial encounter converts to ICD-9-CM 995.29 (adv eff med/biol NEC/NOS) and E932.9 (adv eff hormones NEC/NOS). The mapping is approximate, so confirm the match fits the documentation.
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.
