Is T38.906 a billable ICD-10-CM code?

No. T38.906 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does T38.906 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 T38.906?

T38.906 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 T38.906 (T38) and apply to it just the same.

T38.906

T38.906 — Underdosing of unspecified hormone antagonists

Non-billable headerICD-10-CM

T38.906 is a non-billable header ICD-10-CM code for underdosing of unspecified hormone antagonists. 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

Excludes1 inherited from the categories above T38.906

These are not written on T38.906, but they bind it: a note on a category applies to every code beneath it. Billing T38.906 with anything listed here is a denial.

Written on T38 — Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified

mineralocorticoids and their antagonists (T50.0-)
oxytocic hormones (T48.0-)
parathyroid hormones and derivatives (T50.9-)

Risk adjustment

T38.906 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

T38.906 has not changed since FY2024 — no addition, revision or deletion across the FY2024–FY2027 ICD-10-CM releases.

Code to one of these instead T38.906

3 child codes. Green means billable.

Related codes at this level

Codes that share T38.90. If T38.906 is not quite right, the correct code is usually one of these.

Questions about T38.906

Is T38.906 a billable ICD-10-CM code?: No. T38.906 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does T38.906 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 T38.906?: T38.906 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 T38.906 (T38) and apply to it just the same.