F55 vs T36
F55 (Abuse of non-psychoactive substances) compared with T36 (Poisoning by, adverse effect of and underdosing of systemic antibiotics), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).
Can these codes be reported together?
Yes, when both are documented. T36 carries an Excludes2 note covering F55: “abuse of non-dependence-producing substances (F55.-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| F55Abuse of non-psychoactive substances | T36Poisoning by, adverse effect of and underdosing of systemic antibiotics | |
|---|---|---|
| Billing status | Non-billable header | Non-billable header Report instead: T36.0X1A, T36.0X1D, T36.0X1S, T36.0X2A, T36.0X2D |
| Classification | F01-F99 — Mental, Behavioral and Neurodevelopmental Disorders (F01-F99) | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) |
| Definition | Abuse of non-psychoactive substances is a non-billable ICD-10-CM category code (F55). | Poisoning by, adverse effect of and underdosing of systemic antibiotics is a non-billable ICD-10-CM category code (T36). |
| 7th character | — | The appropriate 7th character is to be added to each code from category T36 |
| Includes | — | adverse effect of correct substance properly administered poisoning by overdose of substance poisoning by wrong substance given or taken in error underdosing by (inadvertently) (deliberately) taking less substance than prescribed or instructed |
| Use additional code | — | code(s) to specify: manifestations of poisoning underdosing or failure in dosage during medical and surgical care (Y63.6, Y63.8-Y63.9) |
| Code first | — | , for adverse effects, the nature of the adverse effect, such as: adverse effect NOS (T88.7) |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources