T36.96XS
T36.96XS — Underdosing of unspecified systemic antibiotic, sequela
Billable / specific codeICD-10-CMPOA exempt
T36.96XS is a billable, specific ICD-10-CM code for underdosing of unspecified systemic antibiotic, sequela. It is valid for submission on a claim.
7th character "S" — sequela
The appropriate 7th character is to be added to each code from category T36
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
T36.96XS does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
T36.96XS is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A57473Billing and Coding: Allergy Testing
- A57473Billing and Coding: Allergy Testing
Related codes at this level
Codes that share T36.96. If T36.96XS is not quite right, the correct code is usually one of these.
Questions about T36.96XS
- Is T36.96XS a billable ICD-10-CM code?
- Yes. T36.96XS is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T36.96XS sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50).