T42.6X5S
T42.6X5S: Adverse effect of other antiepileptic and sedative-hypnotic drugs, sequela
Billable / specific codeICD-10-CMPOA exempt
T42.6X5S is a billable, specific ICD-10-CM code for adverse effect of other antiepileptic and sedative-hypnotic drugs, sequela. It is valid for submission on a claim.
Check T42.6X5S with the rest of the claim: free scrubber7th character "S": sequela
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 T42.6X5S
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above T42.6X5S
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
T42.6X5S is named in 16 Medicare coverage policies: 16 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
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Code history
Unchanged in every release from FY2024 to FY2027.