T36 vs Y63
T36 (Poisoning by, adverse effect of and underdosing of systemic antibiotics) compared with Y63 (Failure in dosage during surgical and medical care), 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. Y63 carries an Excludes2 note covering T36: “accidental overdose of drug or wrong drug given in error (T36-T50)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| T36Poisoning by, adverse effect of and underdosing of systemic antibiotics | Y63Failure in dosage during surgical and medical care | |
|---|---|---|
| Billing status | Non-billable header Report instead: T36.0X1A, T36.0X1D, T36.0X1S, T36.0X2A, T36.0X2D | Non-billable header |
| Classification | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) | V00-Y99 — External Causes of Morbidity (V00-Y99) |
| Definition | Poisoning by, adverse effect of and underdosing of systemic antibiotics is a non-billable ICD-10-CM category code (T36). | Failure in dosage during surgical and medical care is a non-billable ICD-10-CM category code (Y63). |
| 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