T48.205A — Adverse effect of unspecified drugs acting on muscles, initial encounter
Is T48.205A billable?
Yes, but T48.205A is an unspecified code. T48.205A is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, T48.205A 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 T48.205A — the more specific alternatives are listed below.
More specific alternatives
- T48.0X1APoisoning by oxytocic drugs, accidental (unintentional), initial encounter
- T48.1X1APoisoning by skeletal muscle relaxants [neuromuscular blocking agents], accidental (unintentional), initial encounter
- T48.3X1APoisoning by antitussives, accidental (unintentional), initial encounter
- T48.4X1APoisoning by expectorants, accidental (unintentional), initial encounter
- T48.5X1APoisoning by other anti-common-cold drugs, accidental (unintentional), initial encounter
T48.205A at a glance
| Code | T48.205A |
|---|---|
| Description | Adverse effect of unspecified drugs acting on muscles, 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 T48.205A?
In T48.205A, the 7th character A means initial encounter. The 7th character is required for T48.205A to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
What Medicare edits apply to T48.205A?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name T48.205A 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 T48.205A group to?
T48.205A 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 T48.205A 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 T48.205A. T48.205A describes a manifestation and cannot be the principal or first-listed diagnosis.
Use additional code — inherited from Chapter 19
Report an additional code alongside T48.205A to fully describe the condition. T48.205A 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 T48.205A to fully describe the condition. T48.205A is sequenced first.
Excludes2 — not included here — inherited from Chapter 19
The conditions below are not part of T48.205A, but a patient may have both at the same time. When documentation supports it, T48.205A and the excluded code may both be reported.
Excludes2 — not included here — inherited from T36-T50
The conditions below are not part of T48.205A, but a patient may have both at the same time. When documentation supports it, T48.205A and the excluded code may both be reported.
How long has T48.205A existed?
T48.205A 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.