MCMCB Pro
T49.5X5S

T49.5X5SAdverse effect of ophthalmological drugs and preparations, sequela

Billable / specific codeICD-10-CMPOA exempt

T49.5X5S is a billable, specific ICD-10-CM code for adverse effect of ophthalmological drugs and preparations, 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 T49

A
initial encounter
D
subsequent encounter
S
sequela

Risk adjustment

T49.5X5S 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

T49.5X5S is named in 12 Medicare coverage policies 12 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

  • A56558Billing and Coding: Allergy Testing
  • A56612Billing and Coding: CT of the Head
  • A56625Billing and Coding: Echocardiography
  • A56844Billing and Coding: RAST Type Tests

Related codes at this level

Codes that share T49.5X5. If T49.5X5S is not quite right, the correct code is usually one of these.

Questions about T49.5X5S

Is T49.5X5S a billable ICD-10-CM code?
Yes. T49.5X5S is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does T49.5X5S 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).
ICD-10-CMFY2026-Apr· effective April 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release — see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.