2024 ICD-10-CM Diagnosis Code T46.2X6S

Underdosing of other antidysrhythmic drugs, sequela

ICD-10-CM Code:
T46.2X6S
ICD-10 Code for:
Underdosing of other antidysrhythmic drugs, 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)

T46.2X6S is a billable diagnosis code used to specify a medical diagnosis of underdosing of other antidysrhythmic drugs, 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.

T46.2X6S is a sequela code, includes a 7th character and should be used for complications that arise as a direct result of a condition like underdosing of other antidysrhythmic drugs. 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.

Clinical Classification

Clinical Information

  • Ajmaline

    an alkaloid found in the root of rauwolfia serpentina, among other plant sources. it is a class 1-a antiarrhythmic agent that apparently acts by changing the shape and threshold of cardiac action potentials.
  • Amiodarone

    an antianginal and class iii antiarrhythmic drug. it increases the duration of ventricular and atrial muscle action by inhibiting potassium channels and voltage-gated sodium channels. there is a resulting decrease in heart rate and in vascular resistance.
  • Aprindine

    a class ib anti-arrhythmia agent used to manage ventricular and supraventricular arrhythmias.
  • Bunaftine

    n-butyl-n-(2-(diethylamino)ethyl)-1-naphthamide. a proposed antiarrhythmic that prolongs myocardial refractory period and stabilizes cell membranes.
  • Disopyramide

    a class i anti-arrhythmic agent (one that interferes directly with the depolarization of the cardiac membrane and thus serves as a membrane-stabilizing agent) with a depressant action on the heart similar to that of guanidine. it also possesses some anticholinergic and local anesthetic properties.
  • Encainide

    one of the anti-arrhythmia agents, it blocks voltage-gated sodium channels and slows conduction within the his-purkinje system and myocardium.
  • Flecainide

    a potent anti-arrhythmia agent, effective in a wide range of ventricular and atrial arrhythmias and tachycardias.
  • Lorajmine

    a monochloroacetyl derivative of ajmaline. it is a class ia antiarrhythmic agent that is rapidly hydrolyzed to ajmaline by plasma and tissue esterases.
  • Mexiletine

    antiarrhythmic agent pharmacologically similar to lidocaine. it may have some anticonvulsant properties.
  • Procainamide

    a class ia antiarrhythmic drug that is structurally-related to procaine.
  • Propafenone

    an antiarrhythmia agent that is particularly effective in ventricular arrhythmias. it also has weak beta-blocking activity.
  • Quinidine

    an optical isomer of quinine, extracted from the bark of the chinchona tree and similar plant species. this alkaloid dampens the excitability of cardiac and skeletal muscles by blocking sodium and potassium currents across cellular membranes. it prolongs cellular action potentials, and decreases automaticity. quinidine also blocks muscarinic and alpha-adrenergic neurotransmission.
  • Tocainide

    an antiarrhythmic agent which exerts a potential- and frequency-dependent block of sodium channels.

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 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)

T46.2X6S 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 T46.2X6S to ICD-9-CM

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

Table of Drugs and Chemicals

The parent code T46.2X6 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
Adenosine (phosphate)T46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
AjmalineT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
AmiodaroneT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
Antidysrhythmic NECT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
AprindineT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
Bretylium tosilateT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
BunaftineT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
CardiacT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
Cardiac
  »depressants
T46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
Cardiac
  »rhythm regulator
T46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
Cardiac
  »rhythm regulator
    »specified NEC
T46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
Chinidin (e)T46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
CibenzolineT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
DisopyramideT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
EncainideT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
FlecainideT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
HydroquinidineT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
LorajmineT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
LorcainideT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
MexiletineT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
Pilsicainide (hydrochloride)T46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
Prajmalium bitartrateT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
ProcainamideT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
Pronestyl (hydrochloride)T46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
PropafenoneT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
QuinagluteT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
QuinidineT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
TocainideT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6

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.