T45.95XD — Adverse effect of unspecified primarily systemic and hematological agent, subsequent encounter
Is T45.95XD billable?
Yes, but T45.95XD is an unspecified code. T45.95XD is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, T45.95XD 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 T45.95XD.
T45.95XD at a glance
| Code | T45.95XD |
|---|---|
| Description | Adverse effect of unspecified primarily systemic and hematological agent, subsequent encounter |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "D" | subsequent encounter |
What does the 7th character "D" mean in T45.95XD?
In T45.95XD, the 7th character D means subsequent encounter. The 7th character is required for T45.95XD to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
What Medicare edits apply to T45.95XD?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name T45.95XD 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 T45.95XD group to?
T45.95XD 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 T45.95XD 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 T45.95XD. T45.95XD describes a manifestation and cannot be the principal or first-listed diagnosis.
Use additional code — inherited from Chapter 19
Report an additional code alongside T45.95XD to fully describe the condition. T45.95XD 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 T45.95XD to fully describe the condition. T45.95XD is sequenced first.
Excludes2 — not included here — inherited from Chapter 19
The conditions below are not part of T45.95XD, but a patient may have both at the same time. When documentation supports it, T45.95XD and the excluded code may both be reported.
Excludes2 — not included here — inherited from T36-T50
The conditions below are not part of T45.95XD, but a patient may have both at the same time. When documentation supports it, T45.95XD and the excluded code may both be reported.
How long has T45.95XD existed?
T45.95XD 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.