2024 ICD-10-CM Diagnosis Code T46.3X5S

Adverse effect of coronary vasodilators, sequela

ICD-10-CM Code:
T46.3X5S
ICD-10 Code for:
Adverse effect of coronary vasodilators, 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)

T46.3X5S is a billable diagnosis code used to specify a medical diagnosis of adverse effect of coronary vasodilators, 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.

T46.3X5S 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 coronary vasodilators. 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 coronary vasodilator
  • Adverse reaction to platelet aggregation inhibitor
  • Adverse reaction to smooth muscle relaxant
  • Adverse reaction to terodiline
  • Dipyridamole adverse reaction
  • Glyceryl trinitrate adverse reaction
  • Glyceryl trinitrate spray adverse reaction
  • Isosorbide dinitrate adverse reaction
  • Isosorbide mononitrate adverse reaction
  • Modified release GTN adverse reaction
  • Modified release isosorbide dinitrate adverse reaction
  • Modified release isosorbide mononitrate adverse reaction
  • Nicorandil adverse reaction
  • Nitrate vasodilator adverse reaction
  • Nitrite-induced flushing
  • Oral glyceryl trinitrate adverse reaction
  • Oral isosorbide dinitrate adverse reaction
  • Parenteral glyceryl trinitrate adverse reaction
  • Parenteral isosorbide dinitrate adverse reaction
  • Pentaerythritol tetranitrate adverse reaction
  • Prenylamine adverse reaction
  • Transdermal glyceryl trinitrate adverse reaction

Clinical Classification

Clinical Information

  • Chromonar

    a coronary vasodilator agent.
  • Dilazep

    coronary vasodilator with some antiarrhythmic activity.
  • Aspirin, Dipyridamole Drug Combination

    a drug combination of aspirin and dipyridamole that functions as a platelet aggregation inhibitor, used to prevent thrombosis and stroke in transient ischemic attack patients.
  • Dipyridamole

    a phosphodiesterase inhibitor that blocks uptake and metabolism of adenosine by erythrocytes and vascular endothelial cells. dipyridamole also potentiates the antiaggregating action of prostacyclin. (from ama drug evaluations annual, 1994, p752)
  • Erythrityl Tetranitrate

    a vasodilator with general properties similar to nitroglycerin. (from martindale, the extra pharmacopoeia, 30th ed, p1020)
  • Heptaminol

    an amino alcohol that has been used as a myocardial stimulant and vasodilator and to relieve bronchospasm. its most common therapeutic use is in orthostatic hypotension. the mechanism of heptaminol's therapeutic actions is not well understood although it has been suggested to affect catecholamine release or calcium metabolism.
  • Hexobendine

    a potent vasoactive agent that dilates cerebral and coronary arteries, but slightly constricts femoral arteries, without any effects on heart rate, blood pressure or cardiac output.
  • Isosorbide Dinitrate

    a vasodilator used in the treatment of angina pectoris. its actions are similar to nitroglycerin but with a slower onset of action.
  • Khellin

    a vasodilator that also has bronchodilatory action. it has been employed in the treatment of angina pectoris, in the treatment of asthma, and in conjunction with ultraviolet light a, has been tried in the treatment of vitiligo. (from martindale, the extra pharmacopoeia, 30th ed, p1024)
  • Molsidomine

    a morpholinyl sydnone imine ethyl ester, having a nitrogen in place of the keto oxygen. it acts as nitric oxide donors and is a vasodilator that has been used in angina pectoris.
  • Nicorandil

    a derivative of the niacinamide that is structurally combined with an organic nitrate. it is a potassium-channel opener that causes vasodilatation of arterioles and large coronary arteries. its nitrate-like properties produce venous vasodilation through stimulation of guanylate cyclase.
  • Oxyfedrine

    a drug used in the treatment of angina pectoris, heart failure, conduction defects, and myocardial infarction. it is a partial agonist at beta adrenergic receptors and acts as a coronary vasodilator and cardiotonic agent.
  • Prenylamine

    a drug formerly used in the treatment of angina pectoris but superseded by less hazardous drugs. prenylamine depletes myocardial catecholamine stores and has some calcium channel blocking activity. (from martindale, the extra pharmacopoeia, 30th ed, p1406)
  • Trapidil

    a coronary vasodilator agent.

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)

T46.3X5S 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 T46.3X5S 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: E942.4 - Adv eff coronary vasodil
    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 T46.3X5 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
AmikhellineT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
BendazolT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
BenziodaroneT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
CarbocromenT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
ChromonarT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Coronary vasodilator NECT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
CromonarT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
DiisopropylamineT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
DilazepT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
DimoxylineT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
DioxylineT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
DipyridamoleT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
EfloxateT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Eritrityl tetranitrateT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Erythrityl tetranitrateT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Erythrol tetranitrateT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
EtafenoneT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
FenalcomineT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
FluorosolT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
HeptaminolT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
HexadilineT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
HexadylamineT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
HexobendineT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
IpriflavoneT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Isoamyl nitriteT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Isosorbide dinitrateT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Itramin tosilateT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
KhellinT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
KhellosideT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
MolsidomineT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
NicorandilT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Nitrate, organicT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Nitrite, amyl (medicinal) (vapor)T46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Nitroglycerin, nitro-glycerol (medicinal)T46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Nitroglycerin, nitro-glycerol (medicinal)
  »nonmedicinal
T46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Nitroglycerin, nitro-glycerol (medicinal)
  »nonmedicinal
    »fumes
T46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Octyl nitriteT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Organonitrate NECT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
OxyfedrineT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
PentaerythritolT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Pentaerythritol
  »chloral
T46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Pentaerythritol
  »tetranitrate NEC
T46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Pentaerythrityl tetranitrateT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
PentrinatT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
PerhexileneT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Perhexiline (maleate)T46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
PeritrateT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
PiridoxilateT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
PrenylamineT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
PropatylnitrateT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Sorbide nitrateT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Sweet niter spiritT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
TenitramineT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
TerodilineT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
TrapidilT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
TrinitrineT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Trolnitrate (phosphate)T46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
VasodilatorT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Vasodilator
  »coronary NEC
T46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Vasodilator
  »peripheral NEC
T46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
VisnadineT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6

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.