2027 ICD-10-CM Diagnosis Code T39.4X6AUnderdosing of antirheumatics, not elsewhere classified, initial encounter

ICD-10-CM Codes›S00–T88›T36-T50›T39

ICD-10-CM T39.4X6A
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

T39.4X6A is a billable ICD-10-CM diagnosis code for underdosing of antirheumatics, not elsewhere classified, 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 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 951. 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
T39.4X6A
Billable Status
Yes — Valid for Submission
Code Describes
Underdosing of antirheumatics, not elsewhere classified, initial encounter
Short Description
Underdosing of antirheumatics, NEC, init
Parent Code
T39.4X6
Underdosing of antirheumatics, not elsewhere classified

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
CategoryT39Poisoning by, adverse effect of and underdosing of nonopioid analgesics, antipyretics and antirheumatics
This CodeT39.4X6AUnderdosing of antirheumatics, not elsewhere classified, initial encounter

Code EditsBilling

Medicare Code Editor checks that affect claim validity for T39.4X6A.

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.

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 nonopioid analgesics, antipyretics and antirheumatics (T39). 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 2027, published by CMS and the National Center for Health Statistics.

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to T39.4X6A: its own notes plus those printed at T39.4, T39, block T36-T50, and Chapter 19. A note printed at a category, block or chapter applies to every code under it.

Includes

Further defines, or gives examples of, the content of the category.

From Block T36-T50 Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances applies to 3,186 codes
  • adverse effect of correct substance properly administered
  • poisoning by overdose of substance
  • poisoning by wrong substance given or taken in error
  • underdosing by (inadvertently) (deliberately) taking less substance than prescribed or instructed

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From T39.4 Poisoning by, adverse effect of and underdosing of antirheumatics, not elsewhere classified applies to 18 codes
  • poisoning by, adverse effect of and underdosing of glucocorticoids (T38.0-)
  • poisoning by, adverse effect of and underdosing of salicylates (T39.0-)
From Block T36-T50 Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances applies to 3,186 codes
  • toxic reaction to local anesthesia in pregnancy (O29.3-)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Block T36-T50 Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances applies to 3,186 codes
  • abuse and dependence of psychoactive substances (F10-F19)
  • abuse of non-dependence-producing substances (F55.-)
  • immunodeficiency due to drugs (D84.821)
  • drug reaction and poisoning affecting newborn (P00-P96)
  • pathological drug intoxication (inebriation) (F10-F19)
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes

Code First

The underlying condition named in the note is sequenced before this code.

From Block T36-T50 Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances applies to 3,186 codes
  • for adverse effects, the nature of the adverse effect, such as:
  • adverse effect NOS (T88.7)
  • aspirin gastritis (K29.-)
  • blood disorders (D56-D76)
  • contact dermatitis (L23-L25)
  • dermatitis due to substances taken internally (L27.-)
  • nephropathy (N14.0-N14.2)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From Block T36-T50 Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances applies to 3,186 codes
  • code(s) to specify:
  • manifestations of poisoning
  • underdosing or failure in dosage during medical and surgical care (Y63.6, Y63.8-Y63.9)
  • underdosing of medication regimen (Z91.12-, Z91.13-)
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • code to identify any retained foreign body, if applicable (Z18.-)

Notes

General instructions on how these codes are used.

From Block T36-T50 Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances applies to 3,186 codes
  • The drug giving rise to the adverse effect should be identified by use of codes from categories T36-T50 with fifth or sixth character 5.
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
  • The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.

7th Character

Every code in the category takes a 7th character from the listed values, with the placeholder X filling any empty positions before it.

From T39 Poisoning by, adverse effect of and underdosing of nonopioid analgesics, antipyretics and antirheumatics applies to 162 codes
  • The appropriate 7th character is to be added to each code from category T39
Values for category T39 Encounter: Initial, Subsequent, Sequela
  • Ainitial encounter this code
  • Dsubsequent encounter
  • Ssequela

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

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

  • Auranofin

    an oral chrysotherapeutic agent for the treatment of rheumatoid arthritis. its exact mechanism of action is unknown, but it is believed to act via immunological mechanisms and alteration of lysosomal enzyme activity. its efficacy is slightly less than that of injected gold salts, but it is better tolerated, and side effects which occur are potentially less serious.

  • Aurothioglucose

    a thioglucose derivative used as an antirheumatic and experimentally to produce obesity in animals.

  • Gold Sodium Thiomalate

    a variable mixture of the mono- and disodium salts of gold thiomalic acid used mainly for its anti-inflammatory action in the treatment of rheumatoid arthritis. it is most effective in active progressive rheumatoid arthritis and of little or no value in the presence of extensive deformities or in the treatment of other forms of arthritis.

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
Analgesic::antirheumatic NECT39.4X1T39.4X2T39.4X3T39.4X4T39.4X5T39.4X6
Antiphlogistic NECT39.4X1T39.4X2T39.4X3T39.4X4T39.4X5T39.4X6
Antirheumatic NECT39.4X1T39.4X2T39.4X3T39.4X4T39.4X5T39.4X6
AuranofinT39.4X1T39.4X2T39.4X3T39.4X4T39.4X5T39.4X6
AurothioglucoseT39.4X1T39.4X2T39.4X3T39.4X4T39.4X5T39.4X6
AurothioglycanideT39.4X1T39.4X2T39.4X3T39.4X4T39.4X5T39.4X6
Aurothiomalate sodiumT39.4X1T39.4X2T39.4X3T39.4X4T39.4X5T39.4X6
AurotioprolT39.4X1T39.4X2T39.4X3T39.4X4T39.4X5T39.4X6
Glucosamine sulfateT39.4X1T39.4X2T39.4X3T39.4X4T39.4X5T39.4X6
Gold::saltsT39.4X1T39.4X2T39.4X3T39.4X4T39.4X5T39.4X6
Indomethacin::farnesilT39.4X1T39.4X2T39.4X3T39.4X4T39.4X5T39.4X6
Sodium::aurothiomalateT39.4X1T39.4X2T39.4X3T39.4X4T39.4X5T39.4X6
Sodium::aurothiosulfateT39.4X1T39.4X2T39.4X3T39.4X4T39.4X5T39.4X6

Patient EducationClinical

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:

Read the full article at MedlinePlus

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

Convert T39.4X6A 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 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About T39.4X6AOverview

Is T39.4X6A (Underdosing of antirheumatics, not elsewhere classified) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report underdosing of antirheumatics, not elsewhere classified, initial encounter on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What does the 7th character A in T39.4X6A mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for underdosing of antirheumatics, not elsewhere classified, such as an emergency visit or first evaluation.

What MS-DRG does T39.4X6A group to?

On inpatient claims, underdosing of antirheumatics, not elsewhere classified, initial encounter maps to MS-DRG 951 (other Factors Influencing Health Status), which carries a relative weight of 0.5574. Higher weights mean higher Medicare reimbursement.

Can T39.4X6A be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because underdosing of antirheumatics, not elsewhere classified, initial encounter describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

Can T39.4X6A be reported with a code from T38.0?

Not as a rule. The Excludes1 note at T39.4, which applies to T39.4X6A, lists "poisoning by, adverse effect of and underdosing of glucocorticoids (T38.0-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).