Is T46.996S a billable ICD-10-CM code?

Yes. T46.996S is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does T46.996S 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 T46.996S?

T46.996S 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 T46.996S (T46) and apply to it just the same.

T46.996S

T46.996S — Underdosing of other agents primarily affecting the cardiovascular system, sequela

Billable / specific codeICD-10-CMPOA exempt

T46.996S is a billable, specific ICD-10-CM code for underdosing of other agents primarily affecting the cardiovascular system, sequela. It is valid for submission on a claim.

7th character "S" — sequela

The appropriate 7th character is to be added to each code from category T46

A: initial encounter
D: subsequent encounter
S: sequela

Excludes1 inherited from the categories above T46.996S

These are not written on T46.996S, but they bind it: a note on a category applies to every code beneath it. Billing T46.996S with anything listed here is a denial.

Written on T46 — Poisoning by, adverse effect of and underdosing of agents primarily affecting the cardiovascular system

poisoning by, adverse effect of and underdosing of metaraminol (T44.4)

Risk adjustment

T46.996S 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

T46.996S is named in 3 Medicare coverage policies — 3 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56612Billing and Coding: CT of the Head
A57473Billing and Coding: Allergy Testing
A57473Billing and Coding: Allergy Testing

Code history

T46.996S has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share T46.996. If T46.996S is not quite right, the correct code is usually one of these.

Questions about T46.996S

Is T46.996S a billable ICD-10-CM code?: Yes. T46.996S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does T46.996S 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 T46.996S?: T46.996S 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 T46.996S (T46) and apply to it just the same.