T42.6X5D
T42.6X5D: Adverse effect of other antiepileptic and sedative-hypnotic drugs, subsequent encounter
Billable / specific codeICD-10-CMPOA exempt
T42.6X5D is a billable, specific ICD-10-CM code for adverse effect of other antiepileptic and sedative-hypnotic drugs, subsequent encounter. It is valid for submission on a claim.
Check T42.6X5D with the rest of the claim: free scrubber7th character "D": subsequent encounter
The appropriate 7th character is to be added to each code from category T42
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Excludes1 inherited from the categories above T42.6X5D
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above T42.6X5D
Not part of this code, but both may be coded when both are present.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
T42.6X5D is named in 17 Medicare coverage policies: 17 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56612Billing and Coding: CT of the Head
- A56625Billing and Coding: Echocardiography
- A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
- A56844Billing and Coding: RAST Type Tests
Code history
Unchanged in every release from FY2024 to FY2027.