T38 — Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified
T38 is a non-billable header ICD-10-CM code for poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.
This code requires a 7th character
The appropriate 7th character is to be added to each code from category T38
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Other codes that can never be billed with T38
These codes carry an Excludes1 note pointing at T38. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading T38 alone.
- T48.6Poisoning by, adverse effect of and underdosing of antiasthmatics, not elsewhere classified
- T48.0Poisoning by, adverse effect of and underdosing of oxytocic drugs
- T39.4Poisoning by, adverse effect of and underdosing of antirheumatics, not elsewhere classified
- T45.1Poisoning by, adverse effect of and underdosing of antineoplastic and immunosuppressive drugs
Risk adjustment
T38 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.
Code to one of these instead T38
10 child codes. Green means billable.
- T38.0Poisoning by, adverse effect of and underdosing of glucocorticoids and synthetic analogues
- T38.1Poisoning by, adverse effect of and underdosing of thyroid hormones and substitutes
- T38.2Poisoning by, adverse effect of and underdosing of antithyroid drugs
- T38.3Poisoning by, adverse effect of and underdosing of insulin and oral hypoglycemic [antidiabetic] drugs
- T38.4Poisoning by, adverse effect of and underdosing of oral contraceptives
- T38.5Poisoning by, adverse effect of and underdosing of other estrogens and progestogens
- T38.6Poisoning by, adverse effect of and underdosing of antigonadotrophins, antiestrogens, antiandrogens, not elsewhere classified
- T38.7Poisoning by, adverse effect of and underdosing of androgens and anabolic congeners
- T38.8Poisoning by, adverse effect of and underdosing of other and unspecified hormones and synthetic substitutes
- T38.9Poisoning by, adverse effect of and underdosing of other and unspecified hormone antagonists
Questions about T38
- Is T38 a billable ICD-10-CM code?
- No. T38 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does T38 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).
- What cannot be coded together with T38?
- T38 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.