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T38.6X1 vs T38.6X5

T38.6X1 (Poisoning by antigonadotrophins, antiestrogens, antiandrogens, not elsewhere classified, accidental (unintentional)) compared with T38.6X5 (Adverse effect of antigonadotrophins, antiestrogens, antiandrogens, not elsewhere classified), from the official CMS tabular data. T38.6X1 and T38.6X5 code the same substance (Antiandrogen) with a different intent.

Relationship

Informational

Drug table relationship

T38.6X1
Poisoning by antigonadotrophins, antiestrogens, antiandrogens, not elsewhere classified, accidental (unintentional)
T38.6X5
Adverse effect of antigonadotrophins, antiestrogens, antiandrogens, not elsewhere classified

Same substance, different circumstance of exposure.

Same substance — adverse effect (Antiandrogen)

Accidental poisoning, intentional self-harm, assault, undetermined intent, adverse effect and underdosing are mutually exclusive columns — exactly one applies to a given encounter.

Source: CMS Table of Drugs and Chemicals

Can these codes be reported together?

Same substance, different intent. T38.6X1 and T38.6X5 code the same substance (Antiandrogen) with a different circumstance of exposure.

From the CMS Table of Drugs and Chemicals: accidental poisoning, intentional self-harm, assault, undetermined intent, adverse effect and underdosing are mutually exclusive columns — only one of them applies to a given encounter.

Side by side

T38.6X1Poisoning by antigonadotrophins, antiestrogens, antiandrogens, not elsewhere classified, accidental (unintentional)T38.6X5Adverse effect of antigonadotrophins, antiestrogens, antiandrogens, not elsewhere classified
Billing statusNon-billable headerNon-billable header
ClassificationS00-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)
DefinitionPoisoning by antigonadotrophins, antiestrogens, antiandrogens, not elsewhere classified, accidental (unintentional) is a non-billable ICD-10-CM category code (T38.6X1).Adverse effect of antigonadotrophins, antiestrogens, antiandrogens, not elsewhere classified is a non-billable ICD-10-CM category code (T38.6X5).
7th characterThe appropriate 7th character is to be added to each code from category T38The appropriate 7th character is to be added to each code from category T38
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
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(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)
, 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