2024 ICD-10-CM Diagnosis Code T44.4X6

Specific Coding Applicable to Underdosing of predominantly alpha-adrenoreceptor agonists

Non-specific codes like T44.4X6 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10-CM codes with a higher level of specificity when coding for underdosing of predominantly alpha-adrenoreceptor agonists:

Clinical Information

• Etilefrine

  a phenylephrine-related beta-1 adrenergic and alpha adrenergic agonist used as a cardiotonic and antihypotensive agent.

• Metaraminol

  a sympathomimetic agent that acts predominantly at alpha-1 adrenergic receptors. it has been used primarily as a vasoconstrictor in the treatment of hypotension.

• Methoxamine

  an alpha-1 adrenergic agonist that causes prolonged peripheral vasoconstriction.

• Norepinephrine

  precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. norepinephrine is the principal transmitter of most postganglionic sympathetic fibers, and of the diffuse projection system in the brain that arises from the locus ceruleus. it is also found in plants and is used pharmacologically as a sympathomimetic.

• Norepinephrine Plasma Membrane Transport Proteins

  sodium chloride-dependent neurotransmitter symporters located primarily on the plasma membrane of noradrenergic neurons. they remove norepinephrine from the extracellular space by high affinity reuptake into presynaptic terminals. the norepinephrine transporter regulates signal amplitude and duration at noradrenergic synapses and is the target of adrenergic uptake inhibitors.

• Phenylethanolamine N-Methyltransferase

  a methyltransferase that catalyzes the reaction of s-adenosyl-l-methionine and phenylethanolamine to yield s-adenosyl-l-homocysteine and n-methylphenylethanolamine. it can act on various phenylethanolamines and converts norepinephrine into epinephrine. (from enzyme nomenclature, 1992) ec 2.1.1.28.

• Receptors, Adrenergic

  cell-surface proteins that bind epinephrine and/or norepinephrine with high affinity and trigger intracellular changes. the two major classes of adrenergic receptors, alpha and beta, were originally discriminated based on their cellular actions but now are distinguished by their relative affinity for characteristic synthetic ligands. adrenergic receptors may also be classified according to the subtypes of g-proteins with which they bind; this scheme does not respect the alpha-beta distinction.

• Phenylephrine

  an alpha-1 adrenergic agonist used as a mydriatic, nasal decongestant, and cardiotonic agent.

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 drugs primarily affecting the autonomic nervous system (T44). Use the following options for the aplicable episode of care:

• A - initial encounter
• D - subsequent encounter
• S - sequela

Table of Drugs and Chemicals

The 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

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.