2026 ICD-10-CM Diagnosis Code T46.0X5AAdverse effect of cardiac-stimulant glycosides and drugs of similar action, initial encounter

ICD-10-CM CodesS00–T88T36-T50T46

ICD-10-CM T46.0X5A
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

T46.0X5A is a billable ICD-10-CM diagnosis code for adverse effect of cardiac-stimulant glycosides and drugs of similar action, 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 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 917 through 918. 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 Adverse effects of drugs and medicaments, initial encounter.

Code Identity

ICD-10-CM Code
T46.0X5A
Billable Status
Yes — Valid for Submission
Code Describes
Adverse effect of cardiac-stimulant glycosides and drugs of similar action, initial encounter
Short Description
Adverse effect of cardi-stim glycos/drug simlar act, init
Parent Code
Adverse effect of cardiac-stimulant glycosides and drugs of similar action

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
CategoryT46Poisoning by, adverse effect of and underdosing of agents primarily affecting the cardiovascular system
This CodeT46.0X5AAdverse effect of cardiac-stimulant glycosides and drugs of similar action, initial encounter

Code EditsBilling

Medicare Code Editor checks that affect claim validity for T46.0X5A.

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.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

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

Coding GuidelinesGuidance

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 applicable episode of care:

  • A - initial encounter
  • D - subsequent encounter
  • S - sequela

Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2026, published by CMS and the National Center for Health Statistics.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR INJ028
Adverse effects of drugs and medicaments, initial encounter
Default principal diagnosis: inpatient No · outpatient Yes

Clinical InformationClinical

  • 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.

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
AcetyldigitoxinT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
AcetyldigoxinT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
AlphaT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Alpha::acetyldigoxinT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Alpha::adrenergic blocking drugT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Alpha::amylaseT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Alpha::tocoferol (acetate)T46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Alpha::tocopherolT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
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)::lanataT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
Digitalis (leaf) (glycoside)::purpureaT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
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::amorphousT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
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 poisonT46.0X1T46.0X2T46.0X3T46.0X4T46.0X5T46.0X6
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 EducationClinical

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.

The full article covers:

  • What is a drug interaction?
  • What are side effects?
  • What are drug allergies?
  • How can I stay safe when taking medicines?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert T46.0X5A to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
995.29 Adv eff med/biol NEC/NOS
ApproximateCombination The match is approximate, and more than one code can be needed to describe the source diagnosis. Confirm with contextual judgment.
ICD-9-CM
E942.1 Adv eff cardiotonics
ApproximateCombination The match is approximate, and more than one code can be needed to describe the source diagnosis. Confirm with contextual judgment.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About T46.0X5AOverview

Is T46.0X5A a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report adverse effect of cardiac-stimulant glycosides and drugs of similar action, initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character A in T46.0X5A mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for adverse effect of cardiac-stimulant glycosides and drugs of similar action, such as an emergency visit or first evaluation.

What MS-DRG does T46.0X5A group to?

On inpatient claims, adverse effect of cardiac-stimulant glycosides and drugs of similar action, initial encounter maps to MS-DRG 917, 918, with relative weights from 0.8571 to 1.5684 depending on complications. Higher weights mean higher Medicare reimbursement.

Can T46.0X5A be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because adverse effect of cardiac-stimulant glycosides and drugs of similar action, initial encounter describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

What is the ICD-9 equivalent of T46.0X5A?

Under the General Equivalence Mappings, adverse effect of cardiac-stimulant glycosides and drugs of similar action, initial encounter converts to ICD-9-CM 995.29 (adv eff med/biol NEC/NOS) and E942.1 (adv eff cardiotonics). The mapping is approximate, so confirm the match fits the documentation.

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.