T40.425D
T40.425D — Adverse effect of tramadol, subsequent encounter
Billable / specific codeICD-10-CMPOA exempt
T40.425D is a billable, specific ICD-10-CM code for adverse effect of tramadol, 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 T40
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
T40.425D 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
T40.425D is named in 7 Medicare coverage policies — 7 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A57473Billing and Coding: Allergy Testing
- A57473Billing and Coding: Allergy Testing
- A60360Billing and Coding: Allergy Diagnostic Testing
- A60363Billing and Coding: Allergy Diagnostic Testing
Related codes at this level
Codes that share T40.425. If T40.425D is not quite right, the correct code is usually one of these.
Questions about T40.425D
- Is T40.425D a billable ICD-10-CM code?
- Yes. T40.425D is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T40.425D 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).