2027 ICD-10-CM Diagnosis Code T42.0X5SAdverse effect of hydantoin derivatives, sequela

ICD-10-CM Codes›S00–T88›T36-T50›T42

ICD-10-CM T42.0X5S
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

T42.0X5S is a billable ICD-10-CM diagnosis code for adverse effect of hydantoin derivatives, sequela. The 7th character S marks it as a sequela code, which reports a problem that remains after the original condition has resolved. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 922 through 923. The code is not accepted as a principal diagnosis by the Medicare Code Editor and exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Poisoning/toxic effect/adverse effects/underdosing, sequela.

Code Identity

ICD-10-CM Code
T42.0X5S
Billable Status
Yes — Valid for Submission
Code Describes
Adverse effect of hydantoin derivatives, sequela
Short Description
Adverse effect of hydantoin derivatives, sequela
Same as the full description in the CMS dataset.
Parent Code
Adverse effect of hydantoin derivatives

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
CategoryT42Poisoning by, adverse effect of and underdosing of antiepileptic, sedative- hypnotic and antiparkinsonism drugs
This CodeT42.0X5SAdverse effect of hydantoin derivatives, sequela

Code EditsBilling

Medicare Code Editor checks that affect claim validity for T42.0X5S.

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)Billing

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Adverse reaction to hydantoin and/or hydantoin derivative
  • Class I antiarrhythmic adverse reaction
  • Drug-induced erythema multiforme
  • Drug-induced lupus erythematosus
  • Drug-induced lupus erythematosus caused by diphenylhydantoin
  • EMPACT syndrome
  • Gingival disease caused by drug
  • Gingival hypertrophy caused by diphenylhydantoin
  • Hypertrophy of gingiva
  • Phenytoin adverse reaction
  • Purple glove syndrome

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 antiepileptic, sedative- hypnotic and antiparkinsonism drugs (T42). 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 T42.0X5S: its own notes plus those printed at T42, 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 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 T42 Poisoning by, adverse effect of and underdosing of antiepileptic, sedative- hypnotic and antiparkinsonism drugs applies to 162 codes
  • drug dependence and related mental and behavioral disorders due to psychoactive substance use (F10.--F19.-)
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 T42 Poisoning by, adverse effect of and underdosing of antiepileptic, sedative- hypnotic and antiparkinsonism drugs applies to 162 codes
  • The appropriate 7th character is to be added to each code from category T42
  • Ainitial encounter
  • Dsubsequent encounter
  • Ssequela this code

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

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name T42.0X5S, its category, or a range that includes it.

Excludes2 1

These codes carry an Excludes2 note naming T42.0X5S: its condition is not part of those codes, and both may be reported when the patient has both.

  • F13.2 Sedative, hypnotic or anxiolytic-related dependence
    sedative, hypnotic, or anxiolytic poisoning (T42.-) names T42.-, which includes this code

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR INJ075
Poisoning/toxic effect/adverse effects/underdosing, sequela
Default principal diagnosis: inpatient No · outpatient Yes

Clinical InformationClinical

  • Mephenytoin

    an anticonvulsant effective in tonic-clonic epilepsy (epilepsy, tonic-clonic). it may cause blood dyscrasias.
  • Phenytoin

    an anticonvulsant that is used to treat a wide variety of seizures. it is also an anti-arrhythmic and a muscle relaxant. the mechanism of therapeutic action is not clear, although several cellular actions have been described including effects on ion channels, active transport, and general membrane stabilization. the mechanism of its muscle relaxant effect appears to involve a reduction in the sensitivity of muscle spindles to stretch. phenytoin has been proposed for several other therapeutic uses, but its use has been limited by its many adverse effects and interactions with other drugs.

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
AlbutoinT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
Anticonvulsant::hydantoinT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
DilantinT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
DiphenylhydantoinT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
EpanutinT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
EthotoinT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
Hydantoin derivative NECT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
MephenytoinT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
MetetoinT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
MethetoinT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
MethoinT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
PhenantoinT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
PhenytoinT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6

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 T42.0X5S to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
909.5 Lte efct advrs efct drug
ApproximateCombination The match is approximate, and more than one code can be needed to describe the source diagnosis. Confirm with contextual judgment.
ICD-9-CM
E936.1 Adv eff hydantoin deriv
ApproximateCombination The match is approximate, and more than one code can be needed to describe the source diagnosis. Confirm with contextual judgment.

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 T42.0X5SOverview

What is the ICD-10 code for adverse effect of hydantoin derivatives, sequela?

The ICD-10-CM code for adverse effect of hydantoin derivatives, sequela is T42.0X5S (sometimes written as T420X5S). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is T42.0X5S (Adverse effect of hydantoin derivatives) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report adverse effect of hydantoin derivatives, sequela on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What does the 7th character S in T42.0X5S mean?

The final character S makes this a sequela code: it reports a lingering problem that remains after the adverse effect of hydantoin derivatives itself has resolved, not the original event.

What MS-DRG does T42.0X5S group to?

On inpatient claims, adverse effect of hydantoin derivatives, sequela maps to MS-DRG 923, 922, with relative weights from 0.9980 to 1.6248 depending on complications. Higher weights mean higher Medicare reimbursement.

Can T42.0X5S be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because adverse effect of hydantoin derivatives, sequela describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.