2024 ICD-10-CM Diagnosis Code T36.0X5A
Adverse effect of penicillins, initial encounter
- ICD-10-CM Code:
- T36.0X5A
- ICD-10 Code for:
- Adverse effect of penicillins, initial encounter
- Is Billable?
- Yes - Valid for Submission
- Chronic Condition Indicator: [1]
- Not chronic
- Code Navigator:
T36.0X5A is a billable diagnosis code used to specify a medical diagnosis of adverse effect of penicillins, initial encounter. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.
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.
T36.0X5A is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like adverse effect of penicillins. According to ICD-10-CM Guidelines an "initial encounter" doesn't necessarily means "initial visit". The 7th character should be used when the patient is undergoing active treatment regardless if new or different providers saw the patient over the course of a treatment. The appropriate 7th character codes should also be used even if the patient delayed seeking treatment for a condition.
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 amoxicillin and/or clavulanic acid
- Adverse reaction to amoxicillin and/or clavulanic acid
- Adverse reaction to ampicillin and/or cloxacillin
- Adverse reaction to ampicillin and/or cloxacillin
- Adverse reaction to ampicillin and/or floxacillin
- Adverse reaction to ampicillin and/or floxacillin
- Adverse reaction to clavulanic acid and/or ticarcillin
- Adverse reaction to clavulanic acid and/or ticarcillin
- Adverse reaction to piperacillin and/or tazobactam
- Adverse reaction to piperacillin and/or tazobactam
- Adverse reaction to pivampicillin and/or pivmecillinam
- Allergic reaction caused by penicillin
- Allergic reaction caused by penicillin
- Amoxycillin adverse reaction
- Ampicillin adverse reaction
- Ampicillin adverse reaction
- Antipseudomonal penicillins adverse reaction
- Azlocillin adverse reaction
- Bacampicillin adverse reaction
- Benethamine penicillin adverse reaction
- Benzathine penicillin adverse reaction
- Benzylpenicillin adverse reaction
- Broad spectrum penicillins adverse reaction
- Broad spectrum penicillins adverse reaction
- Carbenicillin adverse reaction
- Carfecillin adverse reaction
- Ciclacillin adverse reaction
- Cloxacillin adverse reaction
- Epstein-Barr virus infectious mononucleosis
- Flucloxacillin adverse reaction
- Infectious mononucleosis ampicillin reaction
- Infectious mononucleosis exanthem
- Maculopapular drug eruption
- Maculopapular eruption
- Mecillinam adverse reaction
- Methicillin adverse reaction
- Mezlocillin adverse reaction
- Penicillin adverse reaction
- Penicillinase-resistant penicillins adverse reaction
- Penicillinase-sensitive penicillins adverse reaction
- Penicillin-induced anaphylaxis
- Penicillin-induced angioedema-urticaria
- Phenethicillin adverse reaction
- Phenoxymethylpenicillin adverse reaction
- Piperacillin adverse reaction
- Pivampicillin adverse reaction
- Pivmecillinam adverse reaction
- Procaine benzylpenicillin adverse reaction
- Talampicillin adverse reaction
- Temocillin adverse reaction
- Ticarcillin adverse reaction
Clinical Classification
Clinical Category is Adverse effects of drugs and medicaments, initial encounter
- CCSR Category Code: INJ028
- Inpatient Default CCSR: X - Not applicable.
- Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Clinical Information
Amoxicillin
a broad-spectrum semisynthetic antibiotic similar to ampicillin except that its resistance to gastric acid permits higher serum levels with oral administration.Amoxicillin-Potassium Clavulanate Combination
a fixed-ratio combination of amoxicillin trihydrate and potassium clavulanate.Ampicillin
semi-synthetic derivative of penicillin that functions as an orally active broad-spectrum antibiotic.Ampicillin Resistance
nonsusceptibility of a microbe to the action of ampicillin, a penicillin derivative that interferes with cell wall synthesis.Pivampicillin
pivalate ester analog of ampicillin.Talampicillin
an ester of ampicillin which is readily hydrolyzed on absorption to release ampicillin. it is well absorbed from the gastrointestinal tract resulting in a greater bioavailability of ampicillin than can be achieved with equivalent doses of ampicillin.Azlocillin
a semisynthetic ampicillin-derived acylureido penicillin.Carbenicillin
broad-spectrum semisynthetic penicillin derivative used parenterally. it is susceptible to gastric juice and penicillinase and may damage platelet function.Carfecillin
the phenyl ester of carbenicillin that, upon oral administration, is broken down in the intestinal mucosa to the active antibacterial. it is used for urinary tract infections.Penicillinase
a beta-lactamase preferentially cleaving penicillins. (dorland, 28th ed) ec 3.5.2.-.Cloxacillin
a semi-synthetic antibiotic that is a chlorinated derivative of oxacillin.Cyclacillin
a cyclohexylamido analog of penicillanic acid.Dicloxacillin
one of the penicillins which is resistant to penicillinase.Cilastatin, Imipenem Drug Combination
combination of imipenem and cilastatin that is used in the treatment of bacterial infections; cilastatin inhibits renal dehydropeptidase i to prolong the half-life and increase the tissue penetration of imipenem, enhancing its efficacy as an anti-bacterial agent.Imipenem
semisynthetic thienamycin that has a wide spectrum of antibacterial activity against gram-negative and gram-positive aerobic and anaerobic bacteria, including many multiresistant strains. it is stable to beta-lactamases. clinical studies have demonstrated high efficacy in the treatment of infections of various body systems. its effectiveness is enhanced when it is administered in combination with cilastatin, a renal dipeptidase inhibitor.Methicillin
one of the penicillins which is resistant to penicillinase but susceptible to a penicillin-binding protein. it is inactivated by gastric acid so administered by injection.Methicillin Resistance
non-susceptibility of a microbe to the action of methicillin, a semi-synthetic penicillin derivative.Methicillin-Resistant Staphylococcus aureus
a strain of staphylococcus aureus that is non-susceptible to the action of methicillin. the mechanism of resistance usually involves modification of normal or the presence of acquired penicillin binding proteins.Mezlocillin
semisynthetic ampicillin-derived acylureido penicillin. it has been proposed for infections with certain anaerobes and may be useful in inner ear, bile, and cns infections.Nafcillin
a semi-synthetic antibiotic related to penicillin.Oxacillin
an antibiotic similar to flucloxacillin used in resistant staphylococci infections.Piperacillin
semisynthetic, broad-spectrum, ampicillin derived ureidopenicillin antibiotic proposed for pseudomonas infections. it is also used in combination with other antibiotics.Piperacillin, Tazobactam Drug Combination
an antibiotic combination product of piperacillin and tazobactam, a penicillanic acid derivative with enhanced beta-lactamase inhibitory activity, that is used for the intravenous treatment of intra-abdominal, pelvic, and skin infections and for community-acquired pneumonia of moderate severity. it is also used for the treatment of pseudomonas aeruginosa infections.Sulbactam
a beta-lactamase inhibitor with very weak antibacterial action. the compound prevents antibiotic destruction of beta-lactam antibiotics by inhibiting beta-lactamases, thus extending their spectrum activity. combinations of sulbactam with beta-lactam antibiotics have been used successfully for the therapy of infections caused by organisms resistant to the antibiotic alone.Sulbenicillin
semisynthetic penicillin-type antibiotic.Ticarcillin
an antibiotic derived from penicillin similar to carbenicillin in action.
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 systemic antibiotics (T36). 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.
Convert T36.0X5A to ICD-9-CM
- ICD-9-CM Code: 995.29 - Adv eff med/biol NEC/NOS
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: E930.0 - Adv eff penicillins
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 T36.0X5 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.
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.