T39.95XA — Adverse effect of unspecified nonopioid analgesic, antipyretic and antirheumatic, initial encounter
Is T39.95XA billable?
Yes, but T39.95XA is an unspecified code. T39.95XA is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, T39.95XA 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 T39.95XA — the more specific alternatives are listed below.
More specific alternatives
- T39.011APoisoning by aspirin, accidental (unintentional), initial encounter
- T39.1X1APoisoning by 4-Aminophenol derivatives, accidental (unintentional), initial encounter
- T39.2X1APoisoning by pyrazolone derivatives, accidental (unintentional), initial encounter
- T39.311APoisoning by propionic acid derivatives, accidental (unintentional), initial encounter
T39.95XA at a glance
| Code | T39.95XA |
|---|---|
| Description | Adverse effect of unspecified nonopioid analgesic, antipyretic and antirheumatic, 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 T39.95XA?
In T39.95XA, the 7th character A means initial encounter. The 7th character is required for T39.95XA to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
What Medicare edits apply to T39.95XA?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name T39.95XA 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 T39.95XA group to?
T39.95XA 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 T39.95XA 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-)
Code first — inherited from T36-T50
The underlying condition below must be sequenced before T39.95XA. T39.95XA describes a manifestation and cannot be the principal or first-listed diagnosis.
Use additional code — inherited from Chapter 19
Report an additional code alongside T39.95XA to fully describe the condition. T39.95XA 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 T39.95XA to fully describe the condition. T39.95XA is sequenced first.
Excludes2 — not included here — inherited from Chapter 19
The conditions below are not part of T39.95XA, but a patient may have both at the same time. When documentation supports it, T39.95XA and the excluded code may both be reported.
Excludes2 — not included here — inherited from T36-T50
The conditions below are not part of T39.95XA, but a patient may have both at the same time. When documentation supports it, T39.95XA and the excluded code may both be reported.
How long has T39.95XA existed?
T39.95XA 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.