T48.295A vs T48.295D
T48.295A (Adverse effect of other drugs acting on muscles, initial encounter) compared with T48.295D (Adverse effect of other drugs acting on muscles, subsequent encounter), from the official CMS tabular data. T48.295A and T48.295D code the same injury at a different phase of treatment.
Can these codes be reported together?
Same injury, other encounter phase. T48.295A and T48.295D code the same injury at a different phase of treatment, set by the 7th character.
The 7th character records the type of care given at the encounter being coded (ICD-10-CM Official Guidelines, Section I.C.19.a), so one encounter takes one of these, not both.
Side by side
| T48.295AAdverse effect of other drugs acting on muscles, initial encounter | T48.295DAdverse effect of other drugs acting on muscles, subsequent encounter | |
|---|---|---|
| Billing status | Billable | 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 | Adverse effect of other drugs acting on muscles, initial encounter is a billable ICD-10-CM diagnosis code (T48.295A). | Adverse effect of other drugs acting on muscles, subsequent encounter is a billable ICD-10-CM diagnosis code (T48.295D). |
| 7th character | The appropriate 7th character is to be added to each code from category T48 | The appropriate 7th character is to be added to each code from category T48 |
| 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