2027 ICD-10-CM Diagnosis Code T45.7X6AUnderdosing of anticoagulant antagonist, vitamin K and other coagulants, initial encounter

ICD-10-CM Codes›S00–T88›T36-T50›T45

ICD-10-CM T45.7X6A
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

T45.7X6A is a billable ICD-10-CM diagnosis code for underdosing of anticoagulant antagonist, vitamin K and other coagulants, 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
T45.7X6A
Billable Status
Yes — Valid for Submission
Code Describes
Underdosing of anticoagulant antagonist, vitamin K and other coagulants, initial encounter
Short Description
Undrdose of anticoag antagonist, vit K and oth coag, init
Parent Code
Underdosing of anticoagulant antagonist, vitamin K and other coagulants

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
CategoryT45Poisoning by, adverse effect of and underdosing of primarily systemic and hematological agents, not elsewhere classified
This CodeT45.7X6AUnderdosing of anticoagulant antagonist, vitamin K and other coagulants, initial encounter

Code EditsBilling

Medicare Code Editor checks that affect claim validity for T45.7X6A.

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 primarily systemic and hematological agents, not elsewhere classified (T45). 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 T45.7X6A: its own notes plus those printed at T45.7X6, T45, 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 T45.7X6 Underdosing of anticoagulant antagonist, vitamin K and other coagulants applies to 3 codes
  • vitamin K deficiency (E56.1)
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 T45 Poisoning by, adverse effect of and underdosing of primarily systemic and hematological agents, not elsewhere classified applies to 270 codes
  • The appropriate 7th character is to be added to each code from category T45
  • Ainitial encounter this code
  • Dsubsequent encounter
  • Ssequela

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

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name T45.7X6A, its category, or a range that includes it.

Excludes2 1

These codes carry an Excludes2 note naming T45.7X6A: its condition is not part of those codes, and both may be reported when the patient has both.

  • T45.2 Poisoning by, adverse effect of and underdosing of vitamins
    poisoning by, adverse effect of and underdosing of vitamin K (T45.7) names T45.7, which includes this code

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

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
AcetomenaphthoneT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
Antagonist::anticoagulantT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
Anticoagulant NEC::AntagonistT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
Antihemophilic::globulin concentrateT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
Antihemophilic::plasma, driedT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
Antiheparin drugT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
Coagulant NECT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
CotarnineT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
CytozymeT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
EtamsylateT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
EthamsylateT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
Factor::IX complexT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
Gelatin (intravenous)::absorbable (sponge)T45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
GelfoamT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
Heparin (sodium)::action reverserT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
Hexadimethrine (bromide)T45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
MenadiolT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
Menadiol::sodium sulfateT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
MenadioneT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
Menadione::sodium bisulfiteT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
MenaphthoneT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
MenaquinoneT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
MenatetrenoneT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
PhylloquinoneT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
PhytomenadioneT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
PhytonadioneT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
Protamine sulfateT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
Prothrombin::activatorT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
Russel's viper veninT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
Snake venom or bite::hemocoagulaseT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
Sponge, absorbable (gelatin)T45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
ThrombinT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
ThromboplastinT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
Vitamin NEC::K NECT45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
Vitamin NEC::K1T45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6
Vitamin NEC::K2T45.7X1T45.7X2T45.7X3T45.7X4T45.7X5T45.7X6

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 T45.7X6A 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 T45.7X6AOverview

Is T45.7X6A a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report underdosing of anticoagulant antagonist, vitamin K and other coagulants, initial encounter on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What does the 7th character A in T45.7X6A mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for underdosing of anticoagulant antagonist, vitamin K and other coagulants, such as an emergency visit or first evaluation.

What MS-DRG does T45.7X6A group to?

On inpatient claims, underdosing of anticoagulant antagonist, vitamin K and other coagulants, 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 T45.7X6A be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because underdosing of anticoagulant antagonist, vitamin K and other coagulants, initial encounter describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

Can T45.7X6A be reported with E56.1?

Not as a rule. The Excludes1 note at T45.7X6, which applies to T45.7X6A, lists "vitamin K deficiency (E56.1)". 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).