ICDcodes.org
FY2027

T36.95XS — Adverse effect of unspecified systemic antibiotic, sequela

BillableUnspecified

Is T36.95XS billable?

Yes, but T36.95XS is an unspecified code. T36.95XS is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, T36.95XS is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting T36.95XS — the more specific alternatives are listed below.

More specific alternatives

T36.95XS at a glance

CodeT36.95XS
DescriptionAdverse effect of unspecified systemic antibiotic, sequela
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027
7th character "S"sequela

What does the 7th character "S" mean in T36.95XS?

In T36.95XS, the 7th character S means sequela. The 7th character is required for T36.95XS to be a valid, complete code.

Same condition, different episode of care — switch the 7th character:

What Medicare edits apply to T36.95XS?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name T36.95XS directly.

Cannot be a principal diagnosis — MCE edit 9

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 T36.95XS group to?

T36.95XS sits in MDC 21 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

  • 922Other Injury, Poisoning and Toxic Effect Diagnoses with MCCmedical
  • 923Other Injury, Poisoning and Toxic Effect Diagnoses without MCCmedical

Excludes1 — never code together — inherited from T36-T50

The conditions below can never be reported together with T36.95XS 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 T36.95XS on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • antineoplastic antibiotics (T45.1-)
  • locally applied antibiotic NEC (T49.0)
  • topically used antibiotic for ear, nose and throat (T49.6)
  • topically used antibiotic for eye (T49.5)

Code first — inherited from T36-T50

The underlying condition below must be sequenced before T36.95XS. T36.95XS describes a manifestation and cannot be the principal or first-listed diagnosis.

  • , for adverse effects, the nature of the adverse effect, such as:
  • adverse effect NOS (T88.7)
  • aspirin gastritis (K29.-)
  • blood disorders (D56-D76)
  • contact dermatitis (L23-L25)
  • dermatitis due to substances taken internally (L27.-)
  • nephropathy (N14.0-N14.2)

Use additional code — inherited from Chapter 19

Report an additional code alongside T36.95XS to fully describe the condition. T36.95XS 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 T36.95XS to fully describe the condition. T36.95XS is sequenced first.

  • code(s) to specify:
  • manifestations of poisoning
  • underdosing or failure in dosage during medical and surgical care (Y63.6, Y63.8-Y63.9)
  • underdosing of medication regimen (Z91.12-, Z91.13-)

Excludes2 — not included here — inherited from Chapter 19

The conditions below are not part of T36.95XS, but a patient may have both at the same time. When documentation supports it, T36.95XS and the excluded code may both be reported.

  • birth trauma (P10-P15)
  • obstetric trauma (O70-O71)

Excludes2 — not included here — inherited from T36-T50

The conditions below are not part of T36.95XS, but a patient may have both at the same time. When documentation supports it, T36.95XS and the excluded code may both be reported.

  • abuse and dependence of psychoactive substances (F10-F19)
  • abuse of non-dependence-producing substances (F55.-)
  • immunodeficiency due to drugs (D84.821)
  • drug reaction and poisoning affecting newborn (P00-P96)
  • pathological drug intoxication (inebriation) (F10-F19)

How long has T36.95XS existed?

T36.95XS 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.