T48.995S
T48.995S — Adverse effect of other agents primarily acting on the respiratory system, sequela
Billable / specific codeICD-10-CMPOA exempt
T48.995S is a billable, specific ICD-10-CM code for adverse effect of other agents primarily acting on the respiratory 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 T48
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
T48.995S 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
T48.995S is named in 20 Medicare coverage policies — 20 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56538Billing and Coding: Allergen Immunotherapy
- A56558Billing and Coding: Allergy Testing
- A56612Billing and Coding: CT of the Head
- A56625Billing and Coding: Echocardiography
Related codes at this level
Codes that share T48.995. If T48.995S is not quite right, the correct code is usually one of these.
Questions about T48.995S
- Is T48.995S a billable ICD-10-CM code?
- Yes. T48.995S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T48.995S 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).