T36 vs T82.6XXD
T36 (Poisoning by, adverse effect of and underdosing of systemic antibiotics) compared with T82.6XXD (Infection and inflammatory reaction due to cardiac valve prosthesis, subsequent encounter), 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. T82.6XXD carries an Excludes2 note covering T36: “poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4 or 6)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Sequencing on the claim
1stT82.6XXD then T36
T82.6XXD carries a Use Additional Code instruction covering T36: “code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)”
Side by side
| T36Poisoning by, adverse effect of and underdosing of systemic antibiotics | T82.6XXDInfection and inflammatory reaction due to cardiac valve prosthesis, subsequent encounter | |
|---|---|---|
| Billing status | Non-billable header Report instead: T36.0X1A, T36.0X1D, T36.0X1S, T36.0X2A, T36.0X2D | Billable |
| Classification | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) |
| Definition | Poisoning by, adverse effect of and underdosing of systemic antibiotics is a non-billable ICD-10-CM category code (T36). | Infection and inflammatory reaction due to cardiac valve prosthesis, subsequent encounter is a billable ICD-10-CM diagnosis code (T82.6D). |
| 7th character | The appropriate 7th character is to be added to each code from category T36 | The appropriate 7th character is to be added to each code from category T82 |
| 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 to identify infection code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5) code(s) to identify the specified condition resulting from the complication |
| 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