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

Yes. T88.7XXS is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does T88.7XXS 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 T88.7XXS?

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

T88.7XXS

T88.7XXS — Unspecified adverse effect of drug or medicament, sequela

Billable / specific codeICD-10-CMPOA exempt

T88.7XXS is a billable, specific ICD-10-CM code for unspecified adverse effect of drug or medicament, sequela. It is valid for submission on a claim.

7th character "S" — sequela

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

T88.7XXS 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

T88.7XXS is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52399Billing and Coding: Denosumab (Prolia®, Xgeva®, Jubbonti®, Wyost®, Ospomyv™,Xbryk™,Bomyntra®, Conexxence®, Stoboclo®, Osenvelt®,Bildyos®, Bilprevda®)
A57361Billing and Coding: Monitored Anesthesia Care

Related codes at this level

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

Questions about T88.7XXS

Is T88.7XXS a billable ICD-10-CM code?: Yes. T88.7XXS is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does T88.7XXS 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 T88.7XXS?: T88.7XXS carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.