2024 ICD-10-CM Diagnosis Code T45.515S

Adverse effect of anticoagulants, sequela

ICD-10-CM Code:
T45.515S
ICD-10 Code for:
Adverse effect of anticoagulants, sequela
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)

T45.515S is a billable diagnosis code used to specify a medical diagnosis of adverse effect of anticoagulants, 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.

T45.515S is a sequela code, includes a 7th character and should be used for complications that arise as a direct result of a condition like adverse effect of anticoagulants. 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.

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Acenocoumarol adverse reaction
  • Adverse reaction to coumarin
  • Adverse reaction to danaparoid
  • Adverse reaction to indanedione
  • Anticoagulant adverse reaction
  • Coumarin necrosis
  • Dalteparin adverse reaction
  • Dermatosis caused by coumarin
  • Dermatosis caused by coumarin
  • Dermatosis resulting from anticoagulant therapy
  • Direct acting anticoagulant adverse reaction
  • Enoxaparin adverse reaction
  • Heparin adverse reaction
  • Heparinoid adverse reaction
  • Indirect acting anticoagulant adverse reaction
  • Pesticide adverse reaction
  • Phenindione adverse reaction
  • Tinzaparin adverse reaction
  • Transfusion reaction due to toxic effect of anticoagulant
  • Warfarin adverse reaction
  • Warfarin monitoring status
  • Warfarin side effects

Clinical Classification

Clinical Information

  • Acenocoumarol

    a coumarin that is used as an anticoagulant. its actions and uses are similar to those of warfarin. (from martindale, the extra pharmacopoeia, 30th ed, p233)
  • Phenindione

    an indandione that has been used as an anticoagulant. phenindione has actions similar to warfarin, but it is now rarely employed because of its higher incidence of severe adverse effects. (from martindale, the extra pharmacopoeia, 30th ed, p234)
  • Phenprocoumon

    coumarin derivative that acts as a long acting oral anticoagulant.
  • Warfarin

    an anticoagulant that acts by inhibiting the synthesis of vitamin k-dependent coagulation factors. warfarin is indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, pulmonary embolism, and atrial fibrillation with embolization. it is also used as an adjunct in the prophylaxis of systemic embolism after myocardial infarction. warfarin is also used as a rodenticide.

Coding Guidelines

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 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.

Present on Admission (POA)

T45.515S 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 IndicatorReason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert T45.515S to ICD-9-CM

  • ICD-9-CM Code: 909.5 - Lte efct advrs efct drug
    Combination Flag - Multiple codes are needed to describe the source diagnosis code. Correct coding should be done based on contextual judgment.
  • ICD-9-CM Code: E934.2 - Adv eff anticoagulants
    Combination Flag - Multiple codes are needed to describe the source diagnosis code. Correct coding should be done based on contextual judgment.

Table of Drugs and Chemicals

The parent code T45.515 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
AcenocoumarinT45.511T45.512T45.513T45.514T45.515T45.516
AcenocoumarolT45.511T45.512T45.513T45.514T45.515T45.516
AnisindioneT45.511T45.512T45.513T45.514T45.515T45.516
Anticoagulant NECT45.511T45.512T45.513T45.514T45.515T45.516
Anticoagulant NEC
  »Antagonist
T45.511T45.512T45.513T45.514T45.515T45.516
BishydroxycoumarinT45.511T45.512T45.513T45.514T45.515T45.516
BromindioneT45.511T45.512T45.513T45.514T45.515T45.516
CoumadinT45.511T45.512T45.513T45.514T45.515T45.516
Coumadin
  »rodenticide
T45.511T45.512T45.513T45.514T45.515T45.516
CoumarinT45.511T45.512T45.513T45.514T45.515T45.516
CoumetarolT45.511T45.512T45.513T45.514T45.515T45.516
CumetharolT45.511T45.512T45.513T45.514T45.515T45.516
DaniloneT45.511T45.512T45.513T45.514T45.515T45.516
Dicoumarol, dicoumarin, dicumarolT45.511T45.512T45.513T45.514T45.515T45.516
DiphenadioneT45.511T45.512T45.513T45.514T45.515T45.516
Diphenadione
  »rodenticide
T45.511T45.512T45.513T45.514T45.515T45.516
Drotrecogin alfaT45.511T45.512T45.513T45.514T45.515T45.516
Enoxaparin (sodium)T45.511T45.512T45.513T45.514T45.515T45.516
FluindioneT45.511T45.512T45.513T45.514T45.515T45.516
Heparin (sodium)T45.511T45.512T45.513T45.514T45.515T45.516
Heparin (sodium)
  »action reverser
T45.511T45.512T45.513T45.514T45.515T45.516
Heparin-fractionT45.511T45.512T45.513T45.514T45.515T45.516
Heparinoid (systemic)T45.511T45.512T45.513T45.514T45.515T45.516
Indandione (derivatives)T45.511T45.512T45.513T45.514T45.515T45.516
Indendione (derivatives)T45.511T45.512T45.513T45.514T45.515T45.516
NicoumaloneT45.511T45.512T45.513T45.514T45.515T45.516
PanwarfinT45.511T45.512T45.513T45.514T45.515T45.516
PhenindioneT45.511T45.512T45.513T45.514T45.515T45.516
PhenprocoumonT45.511T45.512T45.513T45.514T45.515T45.516
SintromT45.511T45.512T45.513T45.514T45.515T45.516
TioclomarolT45.511T45.512T45.513T45.514T45.515T45.516
WarfarinT45.511T45.512T45.513T45.514T45.515T45.516
Warfarin
  »rodenticide
T45.511T45.512T45.513T45.514T45.515T45.516
Warfarin
  »sodium
T45.511T45.512T45.513T45.514T45.515T45.516
XigrisT45.511T45.512T45.513T45.514T45.515T45.516
ZovantT45.511T45.512T45.513T45.514T45.515T45.516

Patient Education


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.

What is a drug interaction?

A drug interaction is a change in the way a drug acts in the body when taken with certain other drugs, foods, or supplements or when taken while you have certain medical conditions. Examples include:

  • Two drugs, such as aspirin and blood thinners
  • Drugs and food, such as statins and grapefruit
  • Drugs and supplements, such as gingko and blood thinners
  • Drugs and medical conditions, such as aspirin and peptic ulcers

Interactions could cause a drug to be more or less effective, cause side effects, or change the way one or both drugs work.

What are side effects?

Side effects are unwanted, usually unpleasant, effects caused by medicines. Most are mild, such as a stomachache, dry mouth, or drowsiness, and go away after you stop taking the medicine. Others can be more serious. Sometimes a drug can interact with a disease that you have and cause a side effect. For example, if you have a heart condition, certain decongestants can cause you to have a rapid heartbeat.

What are drug allergies?

Drug allergies are another type of reaction. They can range from mild to life-threatening. Skin reactions, such as hives and rashes, are the most common type. Anaphylaxis, a serious allergic reaction, is less common.

How can I stay safe when taking medicines?

When you start a new prescription or over-the-counter medicine, make sure you understand how to take it correctly. Know which other medicines, foods, and supplements you need to avoid. Always talk to your health care provider or pharmacist if you have questions about your medicines.


[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.