2024 ICD-10-CM Diagnosis Code T44.1X5A

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 acetylcholine
• Bethanechol adverse reaction
• Carbachol adverse reaction
• Methacholine adverse reaction
• Non-allergic anaphylaxis caused by drug
• Non-allergic anaphylaxis caused by parasympathomimetic agent
• Parasympathomimetic adverse reaction
• Pilocarpine adverse reaction

Clinical Information

• Acetylcholine

  a neurotransmitter found at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system.

• Acetylcholine Release Inhibitors

  compounds that block release of the neurotransmitter acetylcholine.

• Acetylcholinesterase

  an enzyme that catalyzes the hydrolysis of acetylcholine to choline and acetate. in the cns, this enzyme plays a role in the function of peripheral neuromuscular junctions. ec 3.1.1.7.

• Cholinergic Agents

  any drug used for its actions on cholinergic systems. included here are agonists and antagonists, drugs that affect the life cycle of acetylcholine, and drugs that affect the survival of cholinergic neurons. the term cholinergic agents is sometimes still used in the narrower sense of muscarinic agonists, although most modern texts discourage that usage.

• Cholinergic Agonists

  drugs that bind to and activate cholinergic receptors.

• Cholinergic Antagonists

  drugs that bind to but do not activate cholinergic receptors, thereby blocking the actions of acetylcholine or cholinergic agonists.

• Cholinesterase Inhibitors

  drugs that inhibit cholinesterases. the neurotransmitter acetylcholine is rapidly hydrolyzed, and thereby inactivated, by cholinesterases. when cholinesterases are inhibited, the action of endogenously released acetylcholine at cholinergic synapses is potentiated. cholinesterase inhibitors are widely used clinically for their potentiation of cholinergic inputs to the gastrointestinal tract and urinary bladder, the eye, and skeletal muscles; they are also used for their effects on the heart and the central nervous system.

• Receptors, Cholinergic

  cell surface proteins that bind acetylcholine with high affinity and trigger intracellular changes influencing the behavior of cells. cholinergic receptors are divided into two major classes, muscarinic and nicotinic, based originally on their affinity for nicotine and muscarine. each group is further subdivided based on pharmacology, location, mode of action, and/or molecular biology.

• Receptors, Muscarinic

  one of the two major classes of cholinergic receptors. muscarinic receptors were originally defined by their preference for muscarine over nicotine. there are several subtypes (usually m1, m2, m3....) that are characterized by their cellular actions, pharmacology, and molecular biology.

• Receptors, Nicotinic

  one of the two major classes of cholinergic receptors. nicotinic receptors were originally distinguished by their preference for nicotine over muscarine. they are generally divided into muscle-type and neuronal-type (previously ganglionic) based on pharmacology, and subunit composition of the receptors.

• Vesicular Acetylcholine Transport Proteins

  vesicular amine transporter proteins that transport the neurotransmitter acetylcholine into small secretory vesicles. proteins of this family contain 12 transmembrane domains and exchange vesicular protons for cytoplasmic acetylcholine.

• Arecoline

  an alkaloid obtained from the betel nut (areca catechu), fruit of a palm tree. it is an agonist at both muscarinic and nicotinic acetylcholine receptors. it is used in the form of various salts as a ganglionic stimulant, a parasympathomimetic, and a vermifuge, especially in veterinary practice. it has been used as a euphoriant in the pacific islands.

• Bethanechol

  a slowly hydrolyzing muscarinic agonist with no nicotinic effects. bethanechol is generally used to increase smooth muscle tone, as in the gi tract following abdominal surgery or in urinary retention in the absence of obstruction. it may cause hypotension, heart rate changes, and bronchial spasm.

• Bethanechol Compounds

  quaternary ammonium compounds that include bethanechol.

• Carbachol

  a slowly hydrolyzed cholinergic agonist that acts at both muscarinic receptors and nicotinic receptors.

• Pilocarpine

  a slowly hydrolyzed muscarinic agonist with no nicotinic effects. pilocarpine is used as a miotic and in the treatment of glaucoma.

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 drugs primarily affecting the autonomic nervous system (T44). 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 T44.1X5A 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: E941.0 - Adv eff cholinergics
  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 T44.1X5 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.

Filter table of drugs and chemicals:

Substance	Poisoning Accidental (unintentional)	Poisoning Accidental (self-harm)	Poisoning Assault	Poisoning Undetermined	Adverse effect	Underdosing
Aceclidine	T44.1X1	T44.1X2	T44.1X3	T44.1X4	T44.1X5	T44.1X6
Acetylcholine	T44.1X1	T44.1X2	T44.1X3	T44.1X4	T44.1X5	T44.1X6
Acetylcholine   »chloride	T44.1X1	T44.1X2	T44.1X3	T44.1X4	T44.1X5	T44.1X6
Acetylcholine   »derivative	T44.1X1	T44.1X2	T44.1X3	T44.1X4	T44.1X5	T44.1X6
Arecoline	T44.1X1	T44.1X2	T44.1X3	T44.1X4	T44.1X5	T44.1X6
Benzpyrinium bromide	T44.1X1	T44.1X2	T44.1X3	T44.1X4	T44.1X5	T44.1X6
Bethanechol	T44.1X1	T44.1X2	T44.1X3	T44.1X4	T44.1X5	T44.1X6
Bethanechol   »chloride	T44.1X1	T44.1X2	T44.1X3	T44.1X4	T44.1X5	T44.1X6
Carbachol	T44.1X1	T44.1X2	T44.1X3	T44.1X4	T44.1X5	T44.1X6
Carbamylcholine chloride	T44.1X1	T44.1X2	T44.1X3	T44.1X4	T44.1X5	T44.1X6
Cholinergic (drug) NEC	T44.1X1	T44.1X2	T44.1X3	T44.1X4	T44.1X5	T44.1X6
Cholinergic (drug) NEC   »muscle tone enhancer	T44.1X1	T44.1X2	T44.1X3	T44.1X4	T44.1X5	T44.1X6
Cholinergic (drug) NEC   »organophosphorus	T44.1X1	T44.1X2	T44.1X3	T44.1X4	T44.1X5	T44.1X6
Cholinergic (drug) NEC   »organophosphorus     »insecticide	T44.1X1	T44.1X2	T44.1X3	T44.1X4	T44.1X5	T44.1X6
Cholinergic (drug) NEC   »organophosphorus     »nerve gas	T44.1X1	T44.1X2	T44.1X3	T44.1X4	T44.1X5	T44.1X6
Cholinergic (drug) NEC   »trimethyl ammonium propanediol	T44.1X1	T44.1X2	T44.1X3	T44.1X4	T44.1X5	T44.1X6
Methacholine	T44.1X1	T44.1X2	T44.1X3	T44.1X4	T44.1X5	T44.1X6
Parasympathomimetic drug NEC	T44.1X1	T44.1X2	T44.1X3	T44.1X4	T44.1X5	T44.1X6
Pilocarpine	T44.1X1	T44.1X2	T44.1X3	T44.1X4	T44.1X5	T44.1X6
Pilocarpus (jaborandi) extract	T44.1X1	T44.1X2	T44.1X3	T44.1X4	T44.1X5	T44.1X6

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.