2024 ICD-10-CM Diagnosis Code T49.0X6A
Underdosing of local antifungal, anti-infective and anti-inflammatory drugs, initial encounter
- ICD-10-CM Code:
- T49.0X6A
- ICD-10 Code for:
- Underdosing of local antifung/infect/inflamm drugs, init
- Is Billable?
- Yes - Valid for Submission
- Chronic Condition Indicator: [1]
- Not chronic
- Code Navigator:
T49.0X6A is a billable diagnosis code used to specify a medical diagnosis of underdosing of local antifungal, anti-infective and anti-inflammatory drugs, 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.
T49.0X6A is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like underdosing of local antifungal anti-infective and anti-inflammatory drugs. 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.
Clinical Classification
Clinical Category is Underdosing of drugs and medicaments, initial encounter
- CCSR Category Code: INJ029
- Inpatient Default CCSR: X - Not applicable.
- Outpatient Default CCSR: X - Not applicable.
Clinical Information
Aminacrine
a highly fluorescent anti-infective dye used clinically as a topical antiseptic and experimentally as a mutagen, due to its interaction with dna. it is also used as an intracellular ph indicator.Benzoates
derivatives of benzoic acid. included under this heading are a broad variety of acid forms, salts, esters, and amides that contain the carboxybenzene structure.Benzoic Acid
a fungistatic compound that is widely used as a food preservative. it is conjugated to glycine in the liver and excreted as hippuric acid.Diatrizoate
a commonly used x-ray contrast medium. as diatrizoate meglumine and as diatrizoate sodium, it is used for gastrointestinal studies, angiography, and urography.Meclofenamic Acid
a non-steroidal anti-inflammatory agent with antipyretic and antigranulation activities. it also inhibits prostaglandin biosynthesis.Metrizoic Acid
a diagnostic radiopaque that usually occurs as the sodium salt.Benzoyl Peroxide
a peroxide derivative that has been used topically for burns and as a dermatologic agent in the treatment of acne and poison ivy dermatitis. it is used also as a bleach in the food industry.Benzydamine
a benzyl-indazole having analgesic, antipyretic, and anti-inflammatory effects. it is used to reduce post-surgical and post-traumatic pain and edema and to promote healing. it is also used topically in treatment of rheumatic diseases and inflammation of the mouth and throat.Betamethasone
a glucocorticoid given orally, parenterally, by local injection, by inhalation, or applied topically in the management of various disorders in which corticosteroids are indicated. its lack of mineralocorticoid properties makes betamethasone particularly suitable for treating cerebral edema and congenital adrenal hyperplasia. (from martindale, the extra pharmacopoeia, 30th ed, p724)Betamethasone Valerate
the 17-valerate derivative of betamethasone. it has substantial topical anti-inflammatory activity and relatively low systemic anti-inflammatory activity.Candicidin
mixture of antifungal heptaene macrolides from streptomyces griseus or actinomyces levoris used topically in candidiasis. the antibiotic complex is composed of candicidins a, b, c, and d, of which d is the major component.Anthemis
a plant genus of the family asteraceae that is similar to matricaria but this has tiny chaffy bract scales between each pair of florets. members contain sesquiterpene lactones. other plants with similar common names include ferula; foeniculum; matricaria; chamaemelum and tripleurospermum.Chamaemelum
a plant genus of the family asteraceae that is used in folk medicine as chamomile. other plants with similar common names include matricaria; tripleurospermum and anthemis.Chamomile
common name for several daisy-like plants (matricaria; tripleurospermum; anthemis; chamaemelum) native to europe and western asia, now naturalized in the united states and australia.Matricaria
a plant genus of the family asteraceae. m. chamomilla appears similar to anthemis but this flower disk is conical and hollow and lacks chaffy bract scales and the odor is weaker. the common name of 'manzanilla' is confused with other meanings of the word. 'matricaria chamomilla sensu' is classified by some as tripleurospermum perforata. other plants with similar common names include chamaemelum; tripleurospermum and anthemis.Tripleurospermum
a plant genus of the family asteraceae. it is easily confused with related plants with similar common names of chamomile and mayweed (matricaria; chamaemelum; and anthemis).Chlorhexidine
a disinfectant and topical anti-infective agent used also as mouthwash to prevent oral plaque.Chlorobutanol
a colorless to white crystalline compound with a camphoraceous odor and taste. it is a widely used preservative in various pharmaceutical solutions, especially injectables. also, it is an active ingredient in certain oral sedatives and topical anesthetics.Chlorquinaldol
local anti-infective agent used for skin, gastrointestinal, and vaginal infections with fungi, protozoa, and certain bacteria. in animals, it causes central nervous system damage and is not administered parenterally. it is also used as antiseptic, fungistat, or deodorant.Clobetasol
a derivative of prednisolone with high glucocorticoid activity and low mineralocorticoid activity. absorbed through the skin faster than fluocinonide, it is used topically in treatment of psoriasis but may cause marked adrenocortical suppression.Clotrimazole
an imidazole derivative with a broad spectrum of antimycotic activity. it inhibits biosynthesis of the sterol ergostol, an important component of fungal cell membranes. its action leads to increased membrane permeability and apparent disruption of enzyme systems bound to the membrane.Desonide
a nonfluorinated corticosteroid anti-inflammatory agent used topically for dermatoses.Desoximetasone
a topical anti-inflammatory glucocorticoid used in dermatoses, skin allergies, psoriasis, etc.Diflucortolone
a topical glucocorticoid used in various dermatoses. it is absorbed through the skin, bound to plasma albumin, and may cause adrenal suppression. it is also administered as the valerate.Econazole
an imidazole derivative that is commonly used as a topical antifungal agent.Ethacridine
a topically applied anti-infective agent.Flumethasone
an anti-inflammatory glucocorticoid used in veterinary practice.Fluocinonide
a topical glucocorticoid used in the treatment of eczema.Fluocortolone
a glucocorticoid with anti-inflammatory activity used topically for various skin disorders.Fluorometholone
a glucocorticoid employed, usually as eye drops, in the treatment of allergic and inflammatory conditions of the eye. it has also been used topically in the treatment of various skin disorders. (from martindale, the extra pharmacopoeia, 30th ed, p732)Flurandrenolone
a corticosteroid used topically in the treatment of various skin disorders. it is usually employed as a cream or an ointment, and is also used as a polyethylene tape with an adhesive. (from martindale, the extra pharmacopoeia, 30th ed, p733)Gramicidin
a group of peptide antibiotics from bacillus brevis. gramicidin c or s is a cyclic, ten-amino acid polypeptide and gramicidins a, b, d are linear. gramicidin is one of the two principal components of tyrothricin.Halcinonide
a glucocorticoid used topically in the treatment of dermatitis; eczema; or psoriasis. it may cause skin irritation.Hexachlorophene
a chlorinated bisphenol antiseptic with a bacteriostatic action against gram-positive organisms, but much less effective against gram-negative organisms. it is mainly used in soaps and creams and is an ingredient of various preparations used for skin disorders. (from martindale, the extra pharmacopoeia, 30th ed, p797)Ketoconazole
broad spectrum antifungal agent used for long periods at high doses, especially in immunosuppressed patients.Mafenide
a sulfonamide that inhibits the enzyme carbonic anhydrase and is used as a topical anti-bacterial agent, especially in burn therapy.Merbromin
a once-popular mercury containing topical antiseptic.Miconazole
an imidazole antifungal agent that is used topically and by intravenous infusion.Mupirocin
a topically used antibiotic from a strain of pseudomonas fluorescens. it has shown excellent activity against gram-positive staphylococci and streptococci. the antibiotic is used primarily for the treatment of primary and secondary skin disorders, nasal infections, and wound healing.Natamycin
amphoteric macrolide antifungal antibiotic from streptomyces natalensis or s. chattanoogensis. it is used for a variety of fungal infections, mainly topically.Nitrofurazone
a topical anti-infective agent effective against gram-negative and gram-positive bacteria. it is used for superficial wounds and injuries and skin infections. nitrofurazone has also been administered orally in the treatment of trypanosomiasis.Arylsulfotransferase
a sulfotransferase that catalyzes the sulfation of a phenol in the presence of 3'-phosphoadenylylsulfate as sulfate donor to yield an aryl sulfate and adenosine 3',5'-bisphosphate. a number of aromatic compounds can act as acceptors; however, organic hydroxylamines are not substrates. sulfate conjugation by this enzyme is a major pathway for the biotransformation of phenolic and catechol drugs as well as neurotransmitters. ec 2.8.2.1.Eugenol
a cinnamate derivative of the shikimate pathway found in clove oil and other plants.Monophenol Monooxygenase
an enzyme of the oxidoreductase class that catalyzes the reaction between l-tyrosine, l-dopa, and oxygen to yield l-dopa, dopaquinone, and water. it is a copper protein that acts also on catechols, catalyzing some of the same reactions as catechol oxidase. ec 1.14.18.1.Oxyphenisatin Acetate
a laxative that undergoes enterohepatic circulation. it may cause jaundice.Phenol
an antiseptic and disinfectant aromatic alcohol.Phenolphthalein
an acid-base indicator which is colorless in acid solution, but turns pink to red as the solution becomes alkaline. it is used medicinally as a cathartic.Phenolphthaleins
a family of 3,3-bis(p-hydroxyphenyl)phthalides. they are used as cathartics, indicators, and coloring agents.Phenols
benzene derivatives that include one or more hydroxyl groups attached to the ring structure.Phenolsulfonphthalein
red dye, ph indicator, and diagnostic aid for determination of renal function. it is used also for studies of the gastrointestinal and other systems.Tyrosine Phenol-Lyase
an enzyme that catalyzes the cleavage of tyrosine to phenol, pyruvate, and ammonia. it is a pyridoxal phosphate protein. the enzyme also forms pyruvate from d-tyrosine, l-cysteine, s-methyl-l-cysteine, l-serine, and d-serine, although at a slower rate. ec 4.1.99.2.Proflavine
topical antiseptic used mainly in wound dressings.Propiolactone
disinfectant used in vapor form to sterilize vaccines, grafts, etc. the vapor is very irritating and the liquid form is carcinogenic.Hydrolyzable Tannins
polymeric derivatives of gallic acid that are esters of a sugar.Pyrogallol
a trihydroxybenzene or dihydroxy phenol that can be prepared by heating gallic acid.Carps
common name for a number of different species of fish in the family cyprinidae. this includes, among others, the common carp, crucian carp, grass carp, and silver carp.Fusidic Acid
an antibiotic isolated from the fermentation broth of fusidium coccineum. (from merck index, 11th ed). it acts by inhibiting translocation during protein synthesis.gp100 Melanoma Antigen
a melanosome-associated protein that plays a role in the maturation of the melanosome.Lepisma
a small nocturnal wingless insect with tapering physical outline.Methenamine
an anti-infective agent most commonly used in the treatment of urinary tract infections. its anti-infective action derives from the slow release of formaldehyde by hydrolysis at acidic ph. (from martindale, the extra pharmacopoeia, 30th ed, p173)Oncorhynchus kisutch
an anadromous species of salmon ranging from the arctic and pacific oceans to monterey bay, california and inhabiting ocean and coastal streams. it is familiarly known as the coho or silver salmon. it is relatively small but its light-colored flesh is of good flavor.Pefloxacin
a synthetic broad-spectrum fluoroquinolone antibacterial agent active against most gram-negative and gram-positive bacteria.Plastocyanin
a copper-containing plant protein that is a fundamental link in the electron transport chain of green plants during the photosynthetic conversion of light energy by photophosphorylation into the potential energy of chemical bonds.Potentilla
a plant genus of the family rosaceae. members contain procyanidins and tannins.Silver
an element with the atomic symbol ag, atomic number 47, and atomic weight 107.87. it is a soft metal that is used medically in surgical instruments, dental prostheses, and alloys. long-continued use of silver salts can lead to a form of poisoning known as argyria.Silver Compounds
inorganic compounds that contain silver as an integral part of the molecule.Silver Nitrate
a silver salt with powerful germicidal activity. it has been used topically to prevent ophthalmia neonatorum.Silver Proteins
compounds of silver and proteins used as topical anti-infective agents.Silver Staining
the use of silver, usually silver nitrate, as a reagent for producing contrast or coloration in tissue specimens.Silver Sulfadiazine
antibacterial used topically in burn therapy.Silver-Russell Syndrome
genetically and clinically heterogeneous disorder characterized by low birth weight, postnatal growth retardation, facial dysmorphism, bilateral body asymmetry, and clinodactyly of the fifth fingers. alterations in genetic imprinting are involved. hypomethylation of igf2/h19 locus near an imprinting center region of chromosome 11p15 plays a role in a subset of silver-russell syndrome. hypermethylation of the same chromosomal region, on the other hand, can cause beckwith-wiedemann syndrome. maternal uniparental disomy for chromosome 7 is known to play a role in its etiology.Sulfacetamide
an anti-bacterial agent that is used topically to treat skin infections and orally for urinary tract infections.Thimerosal
an ethylmercury-sulfidobenzoate that has been used as a preservative in vaccines; antivenins; and ointments. it was formerly used as a topical antiseptic. it degrades to ethylmercury and thiosalicylate.Antidepressive Agents
mood-stimulating drugs used primarily in the treatment of affective disorders and related conditions. several monoamine oxidase inhibitors are useful as antidepressants apparently as a long-term consequence of their modulation of catecholamine levels. the tricyclic compounds useful as antidepressive agents (antidepressive agents, tricyclic) also appear to act through brain catecholamine systems. a third group (antidepressive agents, second-generation) is a diverse group of drugs including some that act specifically on serotonergic systems.Thymol
a phenol obtained from thyme oil or other volatile oils used as a stabilizer in pharmaceutical preparations, and as an antiseptic (antibacterial or antifungal) agent.Thymolphthalein
used as a ph indicator and as a reagent for blood after decolorizing the alkaline solution by boiling with zinc dust.Tolnaftate
a synthetic antifungal agent.Tretinoin
an important regulator of gene expression during growth and development, and in neoplasms. tretinoin, also known as retinoic acid and derived from maternal vitamin a, is essential for normal growth; and embryonic development. an excess of tretinoin can be teratogenic. it is used in the treatment of psoriasis; acne vulgaris; and several other skin diseases. it has also been approved for use in promyelocytic leukemia (leukemia, promyelocytic, acute).Triacetin
a triglyceride that is used as an antifungal agent.Triclosan
a diphenyl ether derivative used in cosmetics and toilet soaps as an antiseptic. it has some bacteriostatic and fungistatic action.
Coding Guidelines
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 topical agents primarily affecting skin and mucous membrane and by ophthalmological, otorhinorlaryngological and dental drugs (T49). 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.
Table of Drugs and Chemicals
The parent code T49.0X6 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
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:
- Knowing your medicines. When you get a prescription, ask the name of the medicine and check to make sure that the pharmacy gave you the right medicine. Make sure that you understand how often you should take the medicine and how long you should take it.
- Keeping a list of medicines.
- Write down all of the medicines that you are taking, including the names of your medicines, how much you take, and when you take them. Make sure to include any over-the-counter medicines, vitamins, supplements, and herbs that you take.
- List the medicines that you are allergic to or that have caused you problems in the past.
- Take this list with you every time you see a health care provider.
- Reading medicine labels and following the directions. Don't just rely on your memory - read the medication label every time. Be especially careful when giving medicines to children.
- Asking questions. If you don't know the answers to these questions, ask your health care provider or pharmacist:
- Why am I taking this medicine?
- What are the common side effects?
- What should I do if I have side effects?
- When should I stop this medicine?
- Can I take this medicine with the other medicines and supplements on my list?
- Do I need to avoid certain foods or alcohol while taking this medicine?
Food and Drug Administration
[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.