T45.1X5A — Adverse effect of antineoplastic and immunosuppressive drugs, initial encounter
T45.1X5A is a billable, specific ICD-10-CM code for adverse effect of antineoplastic and immunosuppressive drugs, initial encounter. It is valid for submission on a claim.
7th character "A" — initial encounter
The appropriate 7th character is to be added to each code from category T45
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Excludes1 inherited from the categories above T45.1X5A
These are not written on T45.1X5A, but they bind it: a note on a category applies to every code beneath it. Billing T45.1X5A with anything listed here is a denial.
Risk adjustment
T45.1X5A 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
T45.1X5A is named in 25 Medicare coverage policies — 25 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A54768Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy
- A56476Billing and Coding: Cardiac Radionuclide Imaging
- A56558Billing and Coding: Allergy Testing
Code history
T45.1X5A has not changed since FY2024 — no addition, revision or deletion across the FY2024–FY2027 ICD-10-CM releases.
Related codes at this level
Codes that share T45.1X5. If T45.1X5A is not quite right, the correct code is usually one of these.
Questions about T45.1X5A
- Is T45.1X5A a billable ICD-10-CM code?
- Yes. T45.1X5A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T45.1X5A 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 T45.1X5A?
- T45.1X5A 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 T45.1X5A (T45.1) and apply to it just the same.