T40.426S — Underdosing of tramadol, sequela
Is T40.426S billable?
Yes — T40.426S is billable for FY2027. T40.426S is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. T40.426S may be submitted for encounters from October 1, 2026 through September 30, 2027.
T40.426S at a glance
| Code | T40.426S |
|---|---|
| Description | Underdosing of tramadol, sequela |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "S" | sequela |
What does the 7th character "S" mean in T40.426S?
In T40.426S, the 7th character S means sequela. The 7th character is required for T40.426S to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
What Medicare edits apply to T40.426S?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name T40.426S 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 T40.426S group to?
T40.426S sits in MDC 23 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.
- 949Aftercare with CC/MCCmedical
- 950Aftercare without CC/MCCmedical
Excludes1 — never code together — inherited from T36-T50
The conditions below can never be reported together with T40.426S 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 T40.426S. T40.426S describes a manifestation and cannot be the principal or first-listed diagnosis.
Use additional code — inherited from Chapter 19
Report an additional code alongside T40.426S to fully describe the condition. T40.426S 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 T40.426S to fully describe the condition. T40.426S is sequenced first.
Excludes2 — not included here — inherited from Chapter 19
The conditions below are not part of T40.426S, but a patient may have both at the same time. When documentation supports it, T40.426S and the excluded code may both be reported.
Excludes2 — not included here — inherited from T36-T50
The conditions below are not part of T40.426S, but a patient may have both at the same time. When documentation supports it, T40.426S and the excluded code may both be reported.
Excludes2 — not included here — inherited from T40
The conditions below are not part of T40.426S, but a patient may have both at the same time. When documentation supports it, T40.426S and the excluded code may both be reported.
- drug dependence and related mental and behavioral disorders due to psychoactive substance use (F10.-F19.-)
How long has T40.426S existed?
T40.426S first appears in FY2021 (FY2020 is not available, so it may have appeared then).
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.