2026 ICD-10-CM Diagnosis Code T46.3X6AUnderdosing of coronary vasodilators, initial encounter

ICD-10-CM CodesS00–T88T36-T50T46

ICD-10-CM T46.3X6A
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

T46.3X6A is a billable ICD-10-CM diagnosis code for underdosing of coronary vasodilators, 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). 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 Underdosing of drugs and medicaments, initial encounter.

Code Identity

ICD-10-CM Code
T46.3X6A
Billable Status
Yes — Valid for Submission
Code Describes
Underdosing of coronary vasodilators, initial encounter
Short Description
Underdosing of coronary vasodilators, initial encounter
Same as the full description in the CMS dataset.
Parent Code
Underdosing of coronary vasodilators

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 CodeT46.3X6AUnderdosing of coronary vasodilators, initial encounter

Code EditsBilling

Medicare Code Editor checks that affect claim validity for T46.3X6A.

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.

Coding GuidelinesGuidance

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 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 INJ029
Underdosing of drugs and medicaments, initial encounter
Default principal diagnosis: inpatient No · outpatient No

Clinical InformationClinical

  • 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.

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
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)::nonmedicinalT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Nitroglycerin, nitro-glycerol (medicinal)::nonmedicinal::fumesT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
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::chloralT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Pentaerythritol::tetranitrate NECT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
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 NECT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
Vasodilator::peripheral NECT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6
VisnadineT46.3X1T46.3X2T46.3X3T46.3X4T46.3X5T46.3X6

Patient EducationClinical

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:

Read the full article at MedlinePlus

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

Convert T46.3X6A to ICD-9-CMHistory

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

ICD-9-CM
No Map There is no ICD-9 equivalent for this code.

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 T46.3X6AOverview

Is T46.3X6A (Underdosing of coronary vasodilators) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report underdosing of coronary vasodilators, initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character A in T46.3X6A mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for underdosing of coronary vasodilators, such as an emergency visit or first evaluation.

Can T46.3X6A be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because underdosing of coronary vasodilators, initial encounter describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

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.