2024 ICD-10-CM Diagnosis Code T45.3X6A

Underdosing of enzymes, initial encounter

ICD-10-CM Code:
T45.3X6A
ICD-10 Code for:
Underdosing of enzymes, initial encounter
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Not chronic
Code Navigator:

Code Classification

  • Injury, poisoning and certain other consequences of external causes
    (S00–T88)
    • Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances
      (T36-T50)
      • Poisoning by, adverse effect of and underdosing of primarily systemic and hematological agents, not elsewhere classified
        (T45)

T45.3X6A is a billable diagnosis code used to specify a medical diagnosis of underdosing of enzymes, initial encounter. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

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.

T45.3X6A is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like underdosing of enzymes. According to ICD-10-CM Guidelines an "initial encounter" doesn't necessarily means "initial visit". The 7th character should be used when the patient is undergoing active treatment regardless if new or different providers saw the patient over the course of a treatment. The appropriate 7th character codes should also be used even if the patient delayed seeking treatment for a condition.

Clinical Classification

Clinical Information

  • Bromelains

    protein-digesting and milk-clotting enzymes found in pineapple fruit juice and stem tissue. enzymes from the two sources are distinguished as fruit bromelain and stem bromelain. this enzyme was formerly listed as ec 3.4.22.4.
  • Acatalasia

    a rare autosomal recessive disorder resulting from the absence of catalase activity. though usually asymptomatic, a syndrome of oral ulcerations and gangrene may be present.
  • Catalase

    an oxidoreductase that catalyzes the conversion of hydrogen peroxide to water and oxygen. it is present in many animal cells. a deficiency of this enzyme results in acatalasia.
  • Chymopapain

    a cysteine endopeptidase isolated from papaya latex. preferential cleavage at glutamic and aspartic acid residues. ec 3.4.22.6.
  • Chymases

    a family of neutral serine proteases with chymotrypsin-like activity. chymases are primarily found in the secretory granules of mast cells and are released during mast cell degranulation.
  • Chymotrypsin

    a serine endopeptidase secreted by the pancreas as its zymogen, chymotrypsinogen and carried in the pancreatic juice to the duodenum where it is activated by trypsin. it selectively cleaves aromatic amino acids on the carboxyl side.
  • Chymotrypsinogen

  • Coronavirus 3C Proteases

    3c proteases that occur in species of coronaviridae.
  • Penicillinase

    a beta-lactamase preferentially cleaving penicillins. (dorland, 28th ed) ec 3.5.2.-.
  • Pronase

    a proteolytic enzyme obtained from streptomyces griseus.
  • alpha 1-Antitrypsin

    plasma glycoprotein member of the serpin superfamily which inhibits trypsin; neutrophil elastase; and other proteolytic enzymes.
  • Aprotinin

    a single-chain polypeptide derived from bovine tissues consisting of 58 amino-acid residues. it is an inhibitor of proteolytic enzymes including chymotrypsin; kallikrein; plasmin; and trypsin. it is used in the treatment of hemorrhage associated with raised plasma concentrations of plasmin. it is also used to reduce blood loss and transfusion requirements in patients at high risk of major blood loss during and following open heart surgery with extracorporeal circulation. (reynolds jef(ed): martindale: the extra pharmacopoeia (electronic version). micromedex, inc, englewood, co, 1995)
  • Receptor, PAR-2

    a g-protein-coupled, proteinase-activated receptor that is expressed in a variety of tissues including endothelium; leukocytes; and the gastrointestinal tract. the receptor is activated by trypsin, which cleaves off the n-terminal peptide from the receptor. the new n-terminal peptide is a cryptic ligand for the receptor. the uncleaved receptor can also be activated by the n-terminal peptide present on the activated thrombin receptor and by small synthetic peptides that contain the unmasked n-terminal sequence.
  • Trypsin

    a serine endopeptidase that is formed from trypsinogen in the pancreas. it is converted into its active form by enteropeptidase in the small intestine. it catalyzes hydrolysis of the carboxyl group of either arginine or lysine. ec 3.4.21.4.
  • Trypsin Inhibitor, Bowman-Birk Soybean

    a low-molecular-weight protein (minimum molecular weight 8000) which has the ability to inhibit trypsin as well as chymotrypsin at independent binding sites. it is characterized by a high cystine content and the absence of glycine.
  • Trypsin Inhibitor, Kazal Pancreatic

    a secreted kazal motif-containing serine peptidase inhibitor that inhibits trypsin. it is a protein composed of 56 amino acid residues and is different in amino acid composition and physiological activity from the kunitz bovine pancreatic trypsin inhibitor (aprotinin). it protects against the trypsin-mediated premature activation of enzyme precursors in the pancreas. mutations in the spink1 gene are associated with chronic pancreatitis.
  • Trypsin Inhibitor, Kunitz Soybean

    a high-molecular-weight protein (approximately 22,500) containing 198 amino acid residues. it is a strong inhibitor of trypsin and human plasmin.
  • Trypsin Inhibitors

    serine proteinase inhibitors which inhibit trypsin. they may be endogenous or exogenous compounds.
  • Trypsinogen

    the inactive proenzyme of trypsin secreted by the pancreas, activated in the duodenum via cleavage by enteropeptidase. (stedman, 25th ed)

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 primarily systemic and hematological agents, not elsewhere classified (T45). 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.

Convert T45.3X6A to ICD-9-CM

  • ICD-9-CM Code: -
    No Map Flag -

Table of Drugs and Chemicals

The parent code T45.3X6 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.

Substance Poisoning
Accidental
(unintentional)
Poisoning
Accidental
(self-harm)
Poisoning
Assault
Poisoning
Undetermined
Adverse
effect
Underdosing
AlgluceraseT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
AlidaseT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
BrinaseT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
BromelainsT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
CatalaseT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
ChymarT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
Chymar
  »ophthalmic preparation
T45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
ChymopapainT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
ChymotrypsinT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
Chymotrypsin
  »ophthalmic preparation
T45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
CocarboxylaseT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
Deoxyribonuclease (pancreatic)T45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
DiffusinT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
EnzodaseT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
Enzyme NECT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
Enzyme NEC
  »depolymerizing
T45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
Enzyme NEC
  »fibrolytic
T45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
Enzyme NEC
  »gastric
T45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
Enzyme NEC
  »intestinal
T45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
Enzyme NEC
  »local action
T45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
Enzyme NEC
  »proteolytic
T45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
Enzyme NEC
  »thrombolytic
T45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
HyaluronidaseT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
HyazymeT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
PenicillinaseT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
PronaseT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
SerrapeptaseT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
StreptodornaseT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
SutilainsT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
TrypsinT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6

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


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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.