2024 ICD-10-CM Diagnosis Code T39.396S
Underdosing of other nonsteroidal anti-inflammatory drugs [NSAID], sequela
- ICD-10-CM Code:
- T39.396S
- ICD-10 Code for:
- Underdosing of nonsteroidal anti-inflammatory drugs, sequela
- Is Billable?
- Yes - Valid for Submission
- Chronic Condition Indicator: [1]
- Not chronic
- Code Navigator:
T39.396S is a billable diagnosis code used to specify a medical diagnosis of underdosing of other nonsteroidal anti-inflammatory drugs [nsaid], sequela. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
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.
T39.396S is a sequela code, includes a 7th character and should be used for complications that arise as a direct result of a condition like underdosing of other nonsteroidal anti-inflammatory drugs [nsaid]. According to ICD-10-CM Guidelines a "sequela" code should be used for chronic or residual conditions that are complications of an initial acute disease, illness or injury. The most common sequela is pain. Usually, two diagnosis codes are needed when reporting sequela. The first code describes the nature of the sequela while the second code describes the sequela or late effect.
Clinical Classification
Clinical Category is Poisoning/toxic effect/adverse effects/underdosing, sequela
- CCSR Category Code: INJ075
- Inpatient Default CCSR: X - Not applicable.
- Outpatient Default CCSR: X - Not applicable.
Clinical Information
Diclofenac
a non-steroidal anti-inflammatory agent (nsaid) with antipyretic and analgesic actions. it is primarily available as the sodium salt.Etodolac
a non-steroidal anti-inflammatory agent and cyclooxygenase-2 (cox-2) inhibitor with potent analgesic and anti-arthritic properties. it has been shown to be effective in the treatment of osteoarthritis; rheumatoid arthritis; ankylosing spondylitis; and in the alleviation of postoperative pain (pain, postoperative).Flufenamic Acid
an anthranilic acid derivative with analgesic, anti-inflammatory, and antipyretic properties. it is used in musculoskeletal and joint disorders and administered by mouth and topically. (from martindale, the extra pharmacopoeia, 30th ed, p16)Indomethacin
a non-steroidal anti-inflammatory agent (nsaid) that inhibits cyclooxygenase, which is necessary for the formation of prostaglandins and other autacoids. it also inhibits the motility of polymorphonuclear leukocytes.Meclofenamic Acid
a non-steroidal anti-inflammatory agent with antipyretic and antigranulation activities. it also inhibits prostaglandin biosynthesis.Mefenamic Acid
a non-steroidal anti-inflammatory agent with analgesic, anti-inflammatory, and antipyretic properties. it is an inhibitor of cyclooxygenase.Nabumetone
a butanone non-steroidal anti-inflammatory drug and cyclooxygenase-2 (cox2) inhibitor that is used in the management of pain associated with osteoarthritis and rheumatoid arthritis.Piroxicam
a cyclooxygenase inhibiting, non-steroidal anti-inflammatory agent (nsaid) that is well established in treating rheumatoid arthritis and osteoarthritis and used for musculoskeletal disorders, dysmenorrhea, and postoperative pain. its long half-life enables it to be administered once daily.Sulindac
a sulfinylindene derivative prodrug whose sulfinyl moiety is converted in vivo to an active nsaid analgesic. specifically, the prodrug is converted by liver enzymes to a sulfide which is excreted in the bile and then reabsorbed from the intestine. this helps to maintain constant blood levels with reduced gastrointestinal side effects.Tolmetin
a non-steroidal anti-inflammatory agent (anti-inflammatory agents, non-steroidal) similar in mode of action to indomethacin.
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 nonopioid analgesics, antipyretics and antirheumatics (T39). 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.
Present on Admission (POA)
T39.396S is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.
CMS POA Indicator Options and Definitions
| POA Indicator | Reason for Code | CMS will pay the CC/MCC DRG? |
|---|---|---|
| Y | Diagnosis was present at time of inpatient admission. | YES |
| N | Diagnosis was not present at time of inpatient admission. | NO |
| U | Documentation insufficient to determine if the condition was present at the time of inpatient admission. | NO |
| W | Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission. | YES |
| 1 | Unreported/Not used - Exempt from POA reporting. | NO |
Table of Drugs and Chemicals
The parent code T39.396 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
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
[Learn More in MedlinePlus]
Pain Relievers
Pain relievers are medicines that reduce or relieve headaches, sore muscles, arthritis, or other aches and pains. There are many different pain medicines, and each one has advantages and risks. Some types of pain respond better to certain medicines than others. Each person may also have a slightly different response to a pain reliever.
Over-the-counter (OTC) medicines are good for many types of pain. There are two main types of OTC pain medicines: acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs). Aspirin, naproxen (Aleve), and ibuprofen (Advil, Motrin) are examples of OTC NSAIDs.
If OTC medicines don't relieve your pain, your doctor may prescribe something stronger. Many NSAIDs are also available at higher prescription doses. The most powerful pain relievers are opioids. They are very effective, but they can sometimes have serious side effects. There is also a risk of addiction. Because of the risks, you must use them only under a doctor's supervision.
There are many things you can do to help ease pain. Pain relievers are just one part of a pain treatment plan.
[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.