T36.4X5A — Adverse effect of tetracyclines, initial encounter
Is T36.4X5A billable?
Yes — T36.4X5A is billable for FY2027. T36.4X5A is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. T36.4X5A may be submitted for encounters from October 1, 2026 through September 30, 2027.
T36.4X5A at a glance
| Code | T36.4X5A |
|---|---|
| Description | Adverse effect of tetracyclines, initial encounter |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "A" | initial encounter |
What does the 7th character "A" mean in T36.4X5A?
In T36.4X5A, the 7th character A means initial encounter. The 7th character is required for T36.4X5A to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
What Medicare edits apply to T36.4X5A?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name T36.4X5A directly.
CMS will reject this code as the principal diagnosis on an inpatient claim. It describes something other than the condition chiefly responsible for the admission.
Which MS-DRGs does T36.4X5A group to?
T36.4X5A sits in MDC 15 and helps define the logic of 1 MS-DRG (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 791Prematurity with Major Problemsmedical
Excludes1 — never code together — inherited from T36-T50
The conditions below can never be reported together with T36.4X5A on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- toxic reaction to local anesthesia in pregnancy (O29.3-)
Excludes1 — never code together — inherited from T36
The conditions below can never be reported together with T36.4X5A on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
Code first — inherited from T36-T50
The underlying condition below must be sequenced before T36.4X5A. T36.4X5A describes a manifestation and cannot be the principal or first-listed diagnosis.
Use additional code — inherited from Chapter 19
Report an additional code alongside T36.4X5A to fully describe the condition. T36.4X5A is sequenced first.
- code to identify any retained foreign body, if applicable (Z18.-)
Use additional code — inherited from T36-T50
Report an additional code alongside T36.4X5A to fully describe the condition. T36.4X5A is sequenced first.
Excludes2 — not included here — inherited from Chapter 19
The conditions below are not part of T36.4X5A, but a patient may have both at the same time. When documentation supports it, T36.4X5A and the excluded code may both be reported.
Excludes2 — not included here — inherited from T36-T50
The conditions below are not part of T36.4X5A, but a patient may have both at the same time. When documentation supports it, T36.4X5A and the excluded code may both be reported.
How long has T36.4X5A existed?
T36.4X5A has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.