T45.AX5D — Adverse effect of immune checkpoint inhibitors and immunostimulant drugs, subsequent encounter
T45.AX5D is a billable, specific ICD-10-CM code for adverse effect of immune checkpoint inhibitors and immunostimulant drugs, subsequent encounter. It is valid for submission on a claim.
7th character "D" — subsequent encounter
The appropriate 7th character is to be added to each code from category T45
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
T45.AX5D 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.
Medicare coverage
T45.AX5D is named in 11 Medicare coverage policies — 11 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56558Billing and Coding: Allergy Testing
- A56948Billing and Coding: Lab: Cystatin C Measurement
- A57473Billing and Coding: Allergy Testing
- A57473Billing and Coding: Allergy Testing
Code history
What changed, and when. Derived by diffing consecutive CMS release files — which matters when you are defending a code assigned under an earlier edition.
- addedFY2024-FY2026
Adverse effect of immune checkpoint inhibitors and immunostimulant drugs, subsequent encounter
Related codes at this level
Codes that share T45.AX5. If T45.AX5D is not quite right, the correct code is usually one of these.
Questions about T45.AX5D
- Is T45.AX5D a billable ICD-10-CM code?
- Yes. T45.AX5D is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T45.AX5D 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).