Is T36 a billable ICD-10-CM code?

No. T36 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does T36 sit in the tabular list?

Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50).

What cannot be coded together with T36?

T36 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

T36

T36 — Poisoning by, adverse effect of and underdosing of systemic antibiotics

Non-billable headerICD-10-CM

T36 is a non-billable header ICD-10-CM code for poisoning by, adverse effect of and underdosing of systemic antibiotics. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.

This code requires a 7th character

The appropriate 7th character is to be added to each code from category T36

A: initial encounter
D: subsequent encounter
S: sequela

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

antineoplastic antibiotics (T45.1-)
locally applied antibiotic NEC (T49.0)
topically used antibiotic for ear, nose and throat (T49.6)
topically used antibiotic for eye (T49.5)

Other codes that can never be billed with T36

These codes carry an Excludes1 note pointing at T36. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading T36 alone.

T37.1Poisoning by, adverse effect of and underdosing of antimycobacterial drugs

Risk adjustment

T36 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code to one of these instead T36

11 child codes. Green means billable.

Questions about T36

Is T36 a billable ICD-10-CM code?: No. T36 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does T36 sit in the tabular list?: Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50).
What cannot be coded together with T36?: T36 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.