Skip to main content

T80.6 vs T88.1XXA

T80.6 (Other serum reactions) compared with T88.1XXA (Other complications following immunization, not elsewhere classified, initial encounter), from the official CMS tabular data.

Summary

These codes can be reported together when both conditions are documented, because T88.1XXA lists T80.6 under Excludes2, which marks them as distinct conditions.

Official rule
What is different?

The conditions named and billing status.T80.6 is “Other serum reactions”; T88.1XXA is “Other complications following immunization, not elsewhere classified, initial encounter”. T80.6 is a non-billable header; T88.1XXA is billable.

Registry fact

Can these codes be reported together?

Yes, when both are documented.T88.1XXA lists T80.6 under Excludes2: “other serum reactions (T80.6-)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code. T88.1XXA carries 1 Excludes1 note covering other codes; the side-by-side table quotes them.

Official rule

Is there an Excludes2 relationship?

Yes.T88.1XXA’s tabular entry: “other serum reactions (T80.6-)”. The note covers T80.6.

Official ruleGuide: Excludes1 vs Excludes2

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Is one a parent or header code?

One is a header.T80.6 is a non-billable header, but T88.1XXA is not one of its subdivisions.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Informational

Excludes2 relationship

T88.1XXA
Other complications following immunization, not elsewhere classified, initial encounter
↔
T80.6
Other serum reactions

What we found

Yes, when both are documented.T88.1XXA carries an Excludes2 note covering T80.6: “other serum reactions (T80.6-)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

What to review

Report both only when the documentation supports both conditions; otherwise report the one documented.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source / rule

CMS ICD-10-CM tabular instructional notes

Official guidance behind these answers

  • Section I.A.12.b — Excludes2 · applies to: Excludes2

    A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.

    ICD-10-CM Official Guidelines FY2026

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

T80.6Other serum reactionsT88.1XXAOther complications following immunization, not elsewhere classified, initial encounter
Billing statusNon-billable header

Report instead: T80.61XA, T80.61XD, T80.61XS, T80.62XA, T80.62XD

Billable
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)
DefinitionOther serum reactions is a non-billable ICD-10-CM category code (T80.6).Other complications following immunization, not elsewhere classified, initial encounter is a billable ICD-10-CM diagnosis code (T88.1XXA).
7th characterThe appropriate 7th character is to be added to each code from category T80The appropriate 7th character is to be added to each code from category T88
Includes
complications following perfusion
Intoxication by serum
Protein sickness
Serum rash
Generalized vaccinia
Rash following immunization
Excludes1—
vaccinia not from vaccine (B08.011)
Excludes2
serum hepatitis (B16-B19)
bone marrow transplant rejection (T86.01)
febrile nonhemolytic transfusion reaction (R50.84)
fluid overload due to transfusion (E87.71)
posttransfusion purpura (D69.51)
transfusion associated circulatory overload (TACO) (E87.71)
transfusion (red blood cell) associated hemochromatosis (E83.111)
transfusion related acute lung injury (TRALI) (J95.84)
any encounters with medical care for postprocedural conditions in which no complications are present, such as:
artificial opening status (Z93.-)
closure of external stoma (Z43.-)
fitting and adjustment of external prosthetic device (Z44.-)
burns and corrosions from local applications and irradiation (T20-T32)
complications of surgical procedures during pregnancy, childbirth and the puerperium (O00-O9A)
mechanical complication of respirator [ventilator] (J95.850)
poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4 or 6)
postprocedural fever (R50.82)
specified complications classified elsewhere, such as:
cerebrospinal fluid leak from spinal puncture (G97.0)
colostomy malfunction (K94.0-)
disorders of fluid and electrolyte imbalance (E86-E87)
functional disturbances following cardiac surgery (I97.0-I97.1)
intraoperative and postprocedural complications of specified body systems (D78.-, E36.-, E89.-, G97.3-, G97.4, H59.3-, H59.-, H95.2-, H95.3, I97.4-, I97.5, J95.6-, J95.7, K91.6-, L76.-, M96.-, N99.-)
ostomy complications (J95.0-, K94.-, N99.5-)
postgastric surgery syndromes (K91.1)
postlaminectomy syndrome NEC (M96.1)
postmastectomy lymphedema syndrome (I97.2)
postsurgical blind-loop syndrome (K91.2)
ventilator associated pneumonia (J95.851)
anaphylactic shock due to serum (T80.5-)
other serum reactions (T80.6-)
postimmunization arthropathy (M02.2)
postimmunization encephalitis (G04.02)
postimmunization fever (R50.83)
complication following infusion, transfusion and therapeutic injection (T80.-)
complication following procedure NEC (T81.-)
complications of anesthesia in labor and delivery (O74.-)
complications of anesthesia in pregnancy (O29.-)
complications of anesthesia in puerperium (O89.-)
complications of devices, implants and grafts (T82-T85)
complications of obstetric surgery and procedure (O75.4)
dermatitis due to drugs and medicaments (L23.3, L24.4, L25.1, L27.0-L27.1)
poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4)
specified complications classified elsewhere
any encounters with medical care for postprocedural conditions in which no complications are present, such as:
artificial opening status (Z93.-)
closure of external stoma (Z43.-)
fitting and adjustment of external prosthetic device (Z44.-)
burns and corrosions from local applications and irradiation (T20-T32)
complications of surgical procedures during pregnancy, childbirth and the puerperium (O00-O9A)
mechanical complication of respirator [ventilator] (J95.850)
poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4 or 6)
postprocedural fever (R50.82)
specified complications classified elsewhere, such as:
cerebrospinal fluid leak from spinal puncture (G97.0)
colostomy malfunction (K94.0-)
disorders of fluid and electrolyte imbalance (E86-E87)
functional disturbances following cardiac surgery (I97.0-I97.1)
intraoperative and postprocedural complications of specified body systems (D78.-, E36.-, E89.-, G97.3-, G97.4, H59.3-, H59.-, H95.2-, H95.3, I97.4-, I97.5, J95.6-, J95.7, K91.6-, L76.-, M96.-, N99.-)
ostomy complications (J95.0-, K94.-, N99.5-)
postgastric surgery syndromes (K91.1)
postlaminectomy syndrome NEC (M96.1)
postmastectomy lymphedema syndrome (I97.2)
postsurgical blind-loop syndrome (K91.2)
ventilator associated pneumonia (J95.851)
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)

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

Edit this comparisonCheck a whole claim

Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources