2026 ICD-10-CM Diagnosis Code T48.1X5AAdverse effect of skeletal muscle relaxants [neuromuscular blocking agents], initial encounter

ICD-10-CM CodesS00–T88T36-T50T48

ICD-10-CM T48.1X5A
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

T48.1X5A is a billable ICD-10-CM diagnosis code for adverse effect of skeletal muscle relaxants [neuromuscular blocking agents], 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
T48.1X5A
Billable Status
Yes — Valid for Submission
Code Describes
Adverse effect of skeletal muscle relaxants [neuromuscular blocking agents], initial encounter
Short Description
Adverse effect of skeletal muscle relaxants, init encntr
Parent Code
Adverse effect of skeletal muscle relaxants [neuromuscular blocking agents]

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
CategoryT48Poisoning by, adverse effect of and underdosing of agents primarily acting on smooth and skeletal muscles and the respiratory system
This CodeT48.1X5AAdverse effect of skeletal muscle relaxants [neuromuscular blocking agents], initial encounter

Code EditsBilling

Medicare Code Editor checks that affect claim validity for T48.1X5A.

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 central nervous system muscle-tone depressants
  • Adverse reaction to ganglion blocking drug
  • Adverse reaction to neuromuscular blocking agent
  • Adverse reaction to skeletal muscle relaxants
  • Alcuronium adverse reaction
  • Atracurium adverse reaction
  • Complication due to and following neuromuscular block
  • Depolarizing muscle relaxant adverse reaction
  • Drug-induced apnea
  • Gallamine adverse reaction
  • Methocarbamol adverse reaction
  • Mivacurium adverse reaction
  • Mivacurium apnea
  • Muscle paresis due to and following neuromuscular blockade
  • Non-depolarizing muscle relaxant adverse reaction
  • Pain following administration of agent
  • Pancuronium adverse reaction
  • Rocuronium adverse reaction
  • Suxamethonium adverse reaction
  • Suxamethonium apnea
  • Suxamethonium pains
  • Tubocurarine adverse reaction
  • Vecuronium 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 acting on smooth and skeletal muscles and the respiratory system (T48). 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

  • Succinylcholine

    a quaternary skeletal muscle relaxant usually used in the form of its bromide, chloride, or iodide. it is a depolarizing relaxant, acting in about 30 seconds and with a duration of effect averaging three to five minutes. succinylcholine is used in surgical, anesthetic, and other procedures in which a brief period of muscle relaxation is called for.
  • Vecuronium Bromide

    monoquaternary homolog of pancuronium. a non-depolarizing neuromuscular blocking agent with shorter duration of action than pancuronium. its lack of significant cardiovascular effects and lack of dependence on good kidney function for elimination as well as its short duration of action and easy reversibility provide advantages over, or alternatives to, other established neuromuscular blocking agents.

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
Aclatonium napadisilateT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Alcuronium (chloride)T48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Atracurium besilateT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Carbolonium (bromide)T48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Curare, curarineT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
CyclobenzaprineT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Decamethonium (bromide)T48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Dimethyltubocurarinium chlorideT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Fazadinium bromideT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
FlaxedilT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Gallamine (triethiodide)T48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Hexafluorenium bromideT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Hexafluronium (bromide)T48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
HexanuoreniumT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Hexcarbacholine bromideT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
LaudexiumT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Mivacurium chlorideT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Myoneural blocking agentsT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Neuromuscular blocking drugT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Pancuronium (bromide)T48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Relaxant, muscleT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Relaxant, muscle::anestheticT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Relaxant, muscle::central nervous systemT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Relaxant, muscle::skeletal NECT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Relaxant, muscle::smooth NECT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Skeletal muscle relaxantsT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
SuccinylcholineT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Suxamethonium (chloride)T48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Suxethonium (chloride)T48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
TubocurareT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Tubocurarine (chloride)T48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
UrariT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
Vecuronium bromideT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6
WooraliT48.1X1T48.1X2T48.1X3T48.1X4T48.1X5T48.1X6

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 T48.1X5A 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
E945.2 Adv eff skelet musc relx
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 T48.1X5AOverview

Is T48.1X5A a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report adverse effect of skeletal muscle relaxants [neuromuscular blocking agents], initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character A in T48.1X5A mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for adverse effect of skeletal muscle relaxants [neuromuscular blocking agents], such as an emergency visit or first evaluation.

What MS-DRG does T48.1X5A group to?

On inpatient claims, adverse effect of skeletal muscle relaxants [neuromuscular blocking agents], 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 T48.1X5A be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because adverse effect of skeletal muscle relaxants [neuromuscular blocking agents], 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 T48.1X5A?

Under the General Equivalence Mappings, adverse effect of skeletal muscle relaxants [neuromuscular blocking agents], initial encounter converts to ICD-9-CM 995.29 (adv eff med/biol NEC/NOS) and E945.2 (adv eff skelet musc relx). 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.