ICD-10 Code T46.4X5S

Adverse effect of angiotensin-converting-enzyme inhibitors, sequela

Version 2019 Replaced Code Billable Code Unacceptable Principal Diagnosis POA Exempt
Short Description:Adverse effect of angiotens-convert-enzyme inhibtr, sequela
Long Description:Adverse effect of angiotensin-converting-enzyme inhibitors, sequela

Valid for Submission

ICD-10 T46.4X5S is a billable code used to specify a medical diagnosis of adverse effect of angiotensin-converting-enzyme inhibitors, sequela. The code is valid for the year 2019 for the submission of HIPAA-covered transactions.

Deleted Code

This code was deleted in the 2019 ICD-10 code set with the code(s) listed below. The National Center for Health Statistics (NCHS) has published an update to the ICD-10-CM diagnosis codes which became effective October 1, 2018. This code was replaced for the FY 2019 (October 1, 2018 - September 30, 2019).

  • K59.03 - Drug induced constipation

Code Classification

  • Injury, poisoning and certain other consequences of external causes (S00–T98)
    • Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances (T36-T50)
      • Agents primarily affecting the cardiovascular system (T46)

Information for Medical Professionals

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 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.

Convert T46.4X5S to ICD-9

The following crosswalk between ICD-10 to ICD-9 is based based on the General Equivalence Mappings (GEMS) information:

  • 909.5 - Lte efct advrs efct drug (Combination Flag)
  • E942.6 - Adv eff antihyperten agt (Combination Flag)

Present on Admission (POA)

T46.4X5S 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.

CMS POA Indicator Options and Definitions
POA Indicator CodePOA Reason 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


The following clinical terms are approximate synonyms:

  • ACE inhibitor-aggravated angioedema
  • Acute drug-induced renal failure
  • Acute renal failure due to ACE inhibitor
  • Adverse reaction caused by losartan
  • Angioedema due to angiotensin-converting-enzyme inhibitor
  • Angiotensin II receptor antagonist adverse reaction
  • Angiotensin-converting-enzyme inhibitor adverse reaction
  • Angiotensin-converting-enzyme inhibitor pseudoallergy
  • Benazepril pseudoallergy
  • Captopril adverse reaction
  • Captopril pseudoallergy
  • Cilazapril adverse reaction
  • Cilazapril pseudoallergy
  • Drug-aggravated angioedema-urticaria
  • Drug-induced hyperkalemia
  • Enalapril adverse reaction
  • Enalapril pseudoallergy
  • Fetal captopril/enalapril syndrome
  • Fetal or neonatal effect of maternal use of antihypertensive drug
  • Fosinopril adverse reaction
  • Fosinopril pseudoallergy
  • Hyperkalemia due to angiotensin-converting enzyme inhibitor
  • Imidapril pseudoallergy
  • Intestinal angioedema caused by angiotensin-converting enzyme inhibitor
  • Lisinopril adverse reaction
  • Lisinopril pseudoallergy
  • Losartan pseudoallergy
  • Moexipril pseudoallergy
  • Nephrotoxic acute renal failure
  • Non-allergic drug hypersensitivity disorder
  • Perindopril adverse reaction
  • Perindopril pseudoallergy
  • Pseudoallergy to angiotensin II receptor antagonist
  • Quinapril adverse reaction
  • Quinapril pseudoallergy
  • Ramipril adverse reaction
  • Rampiril pseudoallergy
  • Trandolapril adverse reaction
  • Trandolapril pseudoallergy

Information for Patients

Drug Reactions

Also called: Side effects

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.

One problem is interactions, which may occur between

  • Two drugs, such as aspirin and blood thinners
  • Drugs and food, such as statins and grapefruit
  • Drugs and supplements, such as ginkgo and blood thinners
  • Drugs and diseases, such as aspirin and peptic ulcers

Interactions can change the actions of one or both drugs. The drugs might not work, or you could get side effects.

Side effects are unwanted effects caused by the drugs. Most are mild, such as a stomach aches or drowsiness, and go away after you stop taking the drug. Others can be more serious.

Drug allergies are another type of reaction. They can be mild or life-threatening. Skin reactions, such as hives and rashes, are the most common type. Anaphylaxis, a serious allergic reaction, is more rare.

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

  • Angioedema (Medical Encyclopedia)
  • Drug allergies (Medical Encyclopedia)
  • Drug-induced diarrhea (Medical Encyclopedia)
  • Drug-induced tremor (Medical Encyclopedia)
  • Taking multiple medicines safely (Medical Encyclopedia)

[Read More]

ICD-10 Footnotes

General Equivalence Map Definitions
The ICD-10 and ICD-9 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.

  • Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
  • No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
  • Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.