T50.995A
T50.995A: Adverse effect of other drugs, medicaments and biological substances, initial encounter
Billable / specific codeICD-10-CM
T50.995A is a billable, specific ICD-10-CM code for adverse effect of other drugs, medicaments and biological substances, initial encounter. It is valid for submission on a claim.
Check T50.995A with the rest of the claim: free scrubber7th character "A": initial encounter
The appropriate 7th character is to be added to each code from category T50
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
T50.995A is named in 29 Medicare coverage policies: 29 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52421Billing and Coding: Ibandronate Sodium
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A56531Billing and Coding: Octreotide Acetate for Injectable Suspension (Sandostatin® LAR Depot)
- A56538Billing and Coding: Allergen Immunotherapy
Code history
Unchanged in every release from FY2024 to FY2027.