T49.95XS — Adverse effect of unspecified topical agent, sequela
Is T49.95XS billable?
Yes, but T49.95XS is an unspecified code. T49.95XS is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, T49.95XS 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 T49.95XS — the more specific alternatives are listed below.
More specific alternatives
- T49.0X1SPoisoning by local antifungal, anti-infective and anti-inflammatory drugs, accidental (unintentional), sequela
- T49.1X1SPoisoning by antipruritics, accidental (unintentional), sequela
- T49.2X1SPoisoning by local astringents and local detergents, accidental (unintentional), sequela
- T49.3X1SPoisoning by emollients, demulcents and protectants, accidental (unintentional), sequela
- T49.4X1SPoisoning by keratolytics, keratoplastics, and other hair treatment drugs and preparations, accidental (unintentional), sequela
- T49.5X1SPoisoning by ophthalmological drugs and preparations, accidental (unintentional), sequela
- T49.6X1SPoisoning by otorhinolaryngological drugs and preparations, accidental (unintentional), sequela
- T49.7X1SPoisoning by dental drugs, topically applied, accidental (unintentional), sequela
- T49.8X1SPoisoning by other topical agents, accidental (unintentional), sequela
T49.95XS at a glance
| Code | T49.95XS |
|---|---|
| Description | Adverse effect of unspecified topical agent, 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 T49.95XS?
In T49.95XS, the 7th character S means sequela. The 7th character is required for T49.95XS to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
What Medicare edits apply to T49.95XS?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name T49.95XS 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 T49.95XS group to?
T49.95XS sits in MDC 21 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.
- 922Other Injury, Poisoning and Toxic Effect Diagnoses with MCCmedical
- 923Other Injury, Poisoning and Toxic Effect Diagnoses without MCCmedical
Excludes1 — never code together — inherited from T36-T50
The conditions below can never be reported together with T49.95XS 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 T49.95XS. T49.95XS describes a manifestation and cannot be the principal or first-listed diagnosis.
Use additional code — inherited from Chapter 19
Report an additional code alongside T49.95XS to fully describe the condition. T49.95XS 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 T49.95XS to fully describe the condition. T49.95XS is sequenced first.
Excludes2 — not included here — inherited from Chapter 19
The conditions below are not part of T49.95XS, but a patient may have both at the same time. When documentation supports it, T49.95XS and the excluded code may both be reported.
Excludes2 — not included here — inherited from T36-T50
The conditions below are not part of T49.95XS, but a patient may have both at the same time. When documentation supports it, T49.95XS and the excluded code may both be reported.
How long has T49.95XS existed?
T49.95XS 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.