T38.3X6A — Underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter
T38.3X6A is a billable, specific ICD-10-CM code for underdosing of insulin and oral hypoglycemic [antidiabetic] drugs, initial encounter. It is valid for submission on a claim.
7th character "A" — initial encounter
The appropriate 7th character is to be added to each code from category T38
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Excludes1 inherited from the categories above T38.3X6A
These are not written on T38.3X6A, but they bind it: a note on a category applies to every code beneath it. Billing T38.3X6A with anything listed here is a denial.
Risk adjustment
T38.3X6A 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 history
T38.3X6A has not changed since FY2024 — no addition, revision or deletion across the FY2024–FY2027 ICD-10-CM releases.
Related codes at this level
Codes that share T38.3X6. If T38.3X6A is not quite right, the correct code is usually one of these.
Questions about T38.3X6A
- Is T38.3X6A a billable ICD-10-CM code?
- Yes. T38.3X6A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T38.3X6A 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 T38.3X6A?
- T38.3X6A carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above T38.3X6A (T38) and apply to it just the same.