Is T88.7 a billable ICD-10-CM code?

No. T88.7 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does T88.7 sit in the tabular list?

Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Complications of surgical and medical care, not elsewhere classified (T80-T88).

What cannot be coded together with T88.7?

T88.7 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

T88.7

T88.7 — Unspecified adverse effect of drug or medicament

Non-billable headerICD-10-CM

T88.7 is a non-billable header ICD-10-CM code for unspecified adverse effect of drug or medicament. 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 T88

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.

specified adverse effects of drugs and medicaments (A00-R94 and T80-T88.6, T88.8)

Use additional code

Add a secondary code to capture the detail described below.

code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Drug hypersensitivity NOS
Drug reaction NOS

Risk adjustment

T88.7 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.

How T88.7 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to T88.7.

Complication›chemotherapy NEC(antineoplastic)
Complication›drug NEC
Damage›medication
Effect, adverse›drugs and medicaments
Hypersensitive, hypersensitiveness, hypersensitivity›drug
Reaction›drug NEC

Code to one of these instead T88.7

3 child codes. Green means billable.

Related codes at this level

Codes that share T88. If T88.7 is not quite right, the correct code is usually one of these.

Questions about T88.7

Is T88.7 a billable ICD-10-CM code?: No. T88.7 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does T88.7 sit in the tabular list?: Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Complications of surgical and medical care, not elsewhere classified (T80-T88).
What cannot be coded together with T88.7?: T88.7 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.