T42.75XA — Adverse effect of unspecified antiepileptic and sedative-hypnotic drugs, initial encounter
Is T42.75XA billable?
Yes, but T42.75XA is an unspecified code. T42.75XA is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, T42.75XA 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 T42.75XA — the more specific alternatives are listed below.
More specific alternatives
- T42.0X1APoisoning by hydantoin derivatives, accidental (unintentional), initial encounter
- T42.1X1APoisoning by iminostilbenes, accidental (unintentional), initial encounter
- T42.2X1APoisoning by succinimides and oxazolidinediones, accidental (unintentional), initial encounter
- T42.3X1APoisoning by barbiturates, accidental (unintentional), initial encounter
- T42.4X1APoisoning by benzodiazepines, accidental (unintentional), initial encounter
- T42.5X1APoisoning by mixed antiepileptics, accidental (unintentional), initial encounter
- T42.6X1APoisoning by other antiepileptic and sedative-hypnotic drugs, accidental (unintentional), initial encounter
- T42.8X1APoisoning by antiparkinsonism drugs and other central muscle-tone depressants, accidental (unintentional), initial encounter
T42.75XA at a glance
| Code | T42.75XA |
|---|---|
| Description | Adverse effect of unspecified antiepileptic and sedative-hypnotic drugs, 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 T42.75XA?
In T42.75XA, the 7th character A means initial encounter. The 7th character is required for T42.75XA to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
What Medicare edits apply to T42.75XA?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name T42.75XA 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 T42.75XA group to?
T42.75XA 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 T42.75XA 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 T42.75XA. T42.75XA describes a manifestation and cannot be the principal or first-listed diagnosis.
Use additional code — inherited from Chapter 19
Report an additional code alongside T42.75XA to fully describe the condition. T42.75XA 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 T42.75XA to fully describe the condition. T42.75XA is sequenced first.
Excludes2 — not included here — inherited from Chapter 19
The conditions below are not part of T42.75XA, but a patient may have both at the same time. When documentation supports it, T42.75XA and the excluded code may both be reported.
Excludes2 — not included here — inherited from T36-T50
The conditions below are not part of T42.75XA, but a patient may have both at the same time. When documentation supports it, T42.75XA and the excluded code may both be reported.
Excludes2 — not included here — inherited from T42
The conditions below are not part of T42.75XA, but a patient may have both at the same time. When documentation supports it, T42.75XA 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 T42.75XA existed?
T42.75XA 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.