T80.5 vs T88.6
T80.5 (Anaphylactic reaction due to serum) compared with T88.6 (Anaphylactic reaction due to adverse effect of correct drug or medicament properly administered), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
No — do not report together. T80.5 carries an Excludes1 note covering T88.6: “anaphylactic reaction or shock due to adverse effect of correct medicinal substance properly administered (T88.6)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
No — do not report together. T88.6 carries an Excludes1 note covering T80.5: “anaphylactic reaction due to serum (T80.5-)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Yes, when both are documented. T88.6 carries an Excludes2 note covering T80.5: “complication following infusion, transfusion and therapeutic injection (T80.-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| T80.5Anaphylactic reaction due to serum | T88.6Anaphylactic reaction due to adverse effect of correct drug or medicament properly administered | |
|---|---|---|
| Billing status | Non-billable header Report instead: T80.51XA, T80.51XD, T80.51XS, T80.52XA, T80.52XD | Non-billable header |
| 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 | Anaphylactic reaction due to serum is a non-billable ICD-10-CM category code (T80.5). | Anaphylactic reaction due to adverse effect of correct drug or medicament properly administered is a non-billable ICD-10-CM category code (T88.6). |
| 7th character | The appropriate 7th character is to be added to each code from category T80 | The appropriate 7th character is to be added to each code from category T88 |
| Includes | complications following perfusion Allergic shock due to serum Anaphylactic shock due to serum Anaphylactoid reaction due to serum | Anaphylactic shock due to adverse effect of correct drug or medicament properly administered Anaphylactoid reaction NOS |
| Use additional code | 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 to identify devices involved and details of circumstances (Y62-Y82) | 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 to identify devices involved and details of circumstances (Y62-Y82) |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources