T38.895D
T38.895D — Adverse effect of other hormones and synthetic substitutes, subsequent encounter
Billable / specific codeICD-10-CMPOA exempt
T38.895D is a billable, specific ICD-10-CM code for adverse effect of other hormones and synthetic substitutes, subsequent encounter. It is valid for submission on a claim.
7th character "D" — subsequent encounter
The appropriate 7th character is to be added to each code from category T38
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
T38.895D 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
T38.895D is named in 16 Medicare coverage policies — 16 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56531Billing and Coding: Octreotide Acetate for Injectable Suspension (Sandostatin® LAR Depot)
- A56558Billing and Coding: Allergy Testing
- A56625Billing and Coding: Echocardiography
- A56625Billing and Coding: Echocardiography
Related codes at this level
Codes that share T38.895. If T38.895D is not quite right, the correct code is usually one of these.
Questions about T38.895D
- Is T38.895D a billable ICD-10-CM code?
- Yes. T38.895D is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T38.895D 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).