T88.7XXA: Unspecified adverse effect of drug or medicament, initial encounter
T88.7XXA is a billable, specific ICD-10-CM code for unspecified adverse effect of drug or medicament, initial encounter. It is valid for submission on a claim.
Check T88.7XXA 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 T88
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Excludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Use additional code
Add a secondary code to capture the detail described below.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Drug hypersensitivity NOS
- Drug reaction NOS
Excludes1 inherited from the categories above T88.7XXA
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above T88.7XXA
Not part of this code, but both may be coded when both are present.
Written on T88: Other complications of surgical and medical care, not elsewhere classified
- complication following infusion, transfusion and therapeutic injection (T80.-)
- complication following procedure NEC (T81.-)
- complications of anesthesia in labor and delivery (O74.-)
- complications of anesthesia in pregnancy (O29.-)
- complications of anesthesia in puerperium (O89.-)
- complications of devices, implants and grafts (T82-T85)
- complications of obstetric surgery and procedure (O75.4)
- dermatitis due to drugs and medicaments (L23.3, L24.4, L25.1, L27.0-L27.1)
- poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4)
- specified complications classified elsewhere
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
T88.7XXA is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A57361Billing and Coding: Monitored Anesthesia Care
Code history
Unchanged in every release from FY2024 to FY2027.