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F55 vs T47.96XS

F55 (Abuse of non-psychoactive substances) compared with T47.96XS (Underdosing of unspecified agents primarily affecting the gastrointestinal system, sequela), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2). MedCoder-derived

Can these codes be reported together?

Informational

Excludes2 relationship

T47.96XS
Underdosing of unspecified agents primarily affecting the gastrointestinal system, sequela
↔
F55
Abuse of non-psychoactive substances

What we found

Yes, when both are documented.T47.96XS 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.

What to review

Report both only when the documentation supports both conditions; otherwise report the one documented.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source / rule

CMS ICD-10-CM tabular instructional notes

Side by side

F55Abuse of non-psychoactive substancesT47.96XSUnderdosing of unspecified agents primarily affecting the gastrointestinal system, sequela
Billing statusNon-billable header

Report instead: F55.0, F55.1, F55.2, F55.3, F55.4

Billable
ClassificationF01-F99 — Mental, Behavioral and Neurodevelopmental Disorders (F01-F99)S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)
DefinitionAbuse of non-psychoactive substances is a non-billable ICD-10-CM category code (F55).Underdosing of unspecified agents primarily affecting the gastrointestinal system, sequela is a billable ICD-10-CM diagnosis code (T47.96XS).
7th character—The appropriate 7th character is to be added to each code from category T47
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
Excludes1—
toxic reaction to local anesthesia in pregnancy (O29.3-)
Excludes2
abuse of psychoactive substances (F10-F19)
abuse and dependence of psychoactive substances (F10-F19)
abuse of non-dependence-producing substances (F55.-)
immunodeficiency due to drugs (D84.821)
drug reaction and poisoning affecting newborn (P00-P96)
pathological drug intoxication (inebriation) (F10-F19)
Code first—
, for adverse effects, the nature of the adverse effect, such as:
adverse effect NOS (T88.7)
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)

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

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Derived from the official CMS ICD-10-CM tabular data (FY2026). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources