2026 ICD-10-CM Diagnosis Code T38.896AUnderdosing of other hormones and synthetic substitutes, initial encounter

ICD-10-CM CodesS00–T88T36-T50T38

ICD-10-CM T38.896A
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

T38.896A is a billable ICD-10-CM diagnosis code for underdosing 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). 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
T38.896A
Billable Status
Yes — Valid for Submission
Code Describes
Underdosing of other hormones and synthetic substitutes, initial encounter
Short Description
Underdosing of oth hormones and synthetic substitutes, init
Parent Code
Underdosing of other hormones and synthetic substitutes

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
CategoryT38Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified
This CodeT38.896AUnderdosing of other hormones and synthetic substitutes, initial encounter

Code EditsBilling

Medicare Code Editor checks that affect claim validity for T38.896A.

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 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.

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

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.

SubstanceAccidentalSelf-harmAssaultUndeter­minedAdverse
Effect
Under­dosing
ADHT38.891T38.892T38.893T38.894T38.895T38.896
Antidiuretic hormoneT38.891T38.892T38.893T38.894T38.895T38.896
BuserelinT38.891T38.892T38.893T38.894T38.895T38.896
Chorionic gonadotropinT38.891T38.892T38.893T38.894T38.895T38.896
DDAVPT38.891T38.892T38.893T38.894T38.895T38.896
Deamino-D-arginine vasopressinT38.891T38.892T38.893T38.894T38.895T38.896
DesmopressinT38.891T38.892T38.893T38.894T38.895T38.896
EnterogastroneT38.891T38.892T38.893T38.894T38.895T38.896
FelypressinT38.891T38.892T38.893T38.894T38.895T38.896
GonadorelinT38.891T38.892T38.893T38.894T38.895T38.896
GonadotropinT38.891T38.892T38.893T38.894T38.895T38.896
Gonadotropin::chorionicT38.891T38.892T38.893T38.894T38.895T38.896
Gonadotropin::pituitaryT38.891T38.892T38.893T38.894T38.895T38.896
Hypophysis, posteriorT38.891T38.892T38.893T38.894T38.895T38.896
LeuprolideT38.891T38.892T38.893T38.894T38.895T38.896
LypressinT38.891T38.892T38.893T38.894T38.895T38.896
Lysine vasopressinT38.891T38.892T38.893T38.894T38.895T38.896
Melanocyte-stimulating hormoneT38.891T38.892T38.893T38.894T38.895T38.896
Pitressin (tannate)T38.891T38.892T38.893T38.894T38.895T38.896
Pituitary extracts (posterior)T38.891T38.892T38.893T38.894T38.895T38.896
Pituitary extracts (posterior)::anteriorT38.891T38.892T38.893T38.894T38.895T38.896
PituitrinT38.891T38.892T38.893T38.894T38.895T38.896
Placental hormoneT38.891T38.892T38.893T38.894T38.895T38.896
Posterior pituitary hormone NECT38.891T38.892T38.893T38.894T38.895T38.896
ProtirelinT38.891T38.892T38.893T38.894T38.895T38.896
SermorelinT38.891T38.892T38.893T38.894T38.895T38.896
SomatorelinT38.891T38.892T38.893T38.894T38.895T38.896
TerlipressinT38.891T38.892T38.893T38.894T38.895T38.896
Thymus extractT38.891T38.892T38.893T38.894T38.895T38.896
VasopressinT38.891T38.892T38.893T38.894T38.895T38.896
Vasopressor drugsT38.891T38.892T38.893T38.894T38.895T38.896

Patient EducationClinical

Hormones

Hormones are your body's chemical messengers. They travel in your bloodstream to tissues or organs. They work slowly, over time, and affect many different processes, including:

Read the full article at MedlinePlus

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

Convert T38.896A 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 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About T38.896AOverview

Is T38.896A (Underdosing of other hormones and synthetic substitutes) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report underdosing 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 T38.896A mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for underdosing of other hormones and synthetic substitutes, such as an emergency visit or first evaluation.

Can T38.896A be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because underdosing 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.

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.