Is T38.996 a billable ICD-10-CM code?

No. T38.996 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does T38.996 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).

T38.996

T38.996 — Underdosing of other hormone antagonists

Non-billable headerICD-10-CM

T38.996 is a non-billable header ICD-10-CM code for underdosing of other 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

Risk adjustment

T38.996 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 T38.996

3 child codes. Green means billable.

Related codes at this level

Codes that share T38.99. If T38.996 is not quite right, the correct code is usually one of these.

Questions about T38.996

Is T38.996 a billable ICD-10-CM code?: No. T38.996 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does T38.996 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).