2024 ICD-10-CM Diagnosis Code T46.0X5S

Adverse effect of cardiac-stimulant glycosides and drugs of similar action, sequela

ICD-10-CM Code:
T46.0X5S
ICD-10 Code for:
Adverse effect of cardi-stim glycos/drug simlar act, 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 agents primarily affecting the cardiovascular system
        (T46)

T46.0X5S is a billable diagnosis code used to specify a medical diagnosis of adverse effect of cardiac-stimulant glycosides and drugs of similar action, 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.

T46.0X5S 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 cardiac-stimulant glycosides and drugs of similar action. 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:

  • Adverse reaction to Digitalis glycoside
  • Cardiac inotropic agent adverse reaction
  • Cardiac inotropic agent adverse reaction
  • Cardiac inotropic agent adverse reaction
  • Cardiac inotropic agent adverse reaction
  • Cardiac inotropic agent adverse reaction
  • Cardiac inotropic agent adverse reaction
  • Class IV antiarrhythmic adverse reaction
  • Digitoxin adverse reaction
  • Digoxin adverse reaction
  • Lanatoside C adverse reaction
  • Medigoxin adverse reaction
  • Ouabain adverse reaction

Clinical Classification

Clinical Information

  • Deslanoside

    deacetyllanatoside c. a cardiotonic glycoside from the leaves of digitalis lanata.
  • Acetyldigitoxins

    cardioactive derivatives of lanatoside a or of digitoxin. they are used for fast digitalization in congestive heart failure.
  • Digitoxin

    a cardiac glycoside sometimes used in place of digoxin. it has a longer half-life than digoxin; toxic effects, which are similar to those of digoxin, are longer lasting. (from martindale, the extra pharmacopoeia, 30th ed, p665)
  • Acetyldigoxins

    alpha- or beta-acetyl derivatives of digoxin or lanatoside c from digitalis lanata. they are better absorbed and longer acting than digoxin and are used in congestive heart failure.
  • Digoxin

    a cardiotonic glycoside obtained mainly from digitalis lanata; it consists of three sugars and the aglycone digoxigenin. digoxin has positive inotropic and negative chronotropic activity. it is used to control ventricular rate in atrial fibrillation and in the management of congestive heart failure with atrial fibrillation. its use in congestive heart failure and sinus rhythm is less certain. the margin between toxic and therapeutic doses is small. (from martindale, the extra pharmacopoeia, 30th ed, p666)
  • Lanatosides

    glycosides from digitalis lanata leaf. lanatoside c has actions similar to digoxin. mixtures of lanatosides a, b, and c have also been used. (from martindale, the extra pharmacopoeia, 30th ed, p670)
  • Proscillaridin

    a cardiotonic glycoside isolated from scilla maritima var. alba (squill).
  • Strophanthus

    a plant genus of the family apocynaceae that contains ouabain cardiac glycosides.

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 agents primarily affecting the cardiovascular system (T46). 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)

T46.0X5S 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 T46.0X5S 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: E942.1 - Adv eff cardiotonics
    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 T46.0X5 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
AcetyldigitoxinT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
AcetyldigoxinT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
AlphaT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Alpha
  »acetyldigoxin
T46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Alpha
  »adrenergic blocking drug
T46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Alpha
  »amylase
T46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Alpha
  »tocoferol (acetate)
T46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Alpha
  »tocopherol
T46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
b-acetyldigoxinT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Cardiotonic (glycoside) NECT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
CerberinT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Ch'an suT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Convallaria glycosidesT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Crataegus extractT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
CymarinT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
DeslanosideT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Digitalin (e)T46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Digitalis (leaf) (glycoside)T46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Digitalis (leaf) (glycoside)
  »lanata
T46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Digitalis (leaf) (glycoside)
  »purpurea
T46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
DigitoxinT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
DigitoxoseT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
DigoxinT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
DigoxineT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
GitalinT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Gitalin
  »amorphous
T46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
GitaloxinT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
GitoxinT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Glycoside, cardiac (stimulant)T46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
LanatosidesT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
MeproscillarinT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
MetildigoxinT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
OleandrinT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Ouabain (e)T46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
PengitoxinT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
PeruvosideT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
ProscillaridinT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
SquillT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Squill
  »rat poison
T46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
StrofantinaT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Strophanthin (g) (k)T46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
StrophanthusT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
StrophantinT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Strophantin-gT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6

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.