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ICD-10/T45.95

T45.95 ICD-10-CM Code: Adverse effect of unspecified primarily systemic and hematological agent

Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.

Code Set: Valid FY2026 and FY2027. FY2026 took effect October 1, 2025.

Official Registry Overview & Definition

Adverse effect of unspecified primarily systemic and hematological agent is a non-billable ICD-10-CM category code (T45.95). A more specific billable subcode must be selected for claims submission.

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for T45.95 in the official ICD-10-CM tabular list.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • 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

Excludes1 — Not Coded Here

Conditions that can never be reported with this code; the two are mutually exclusive.

  • toxic reaction to local anesthesia in pregnancy (O29.3-)

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

  • abuse and dependence of psychoactive substances (F10-F19)
  • abuse of non-dependence-producing substances (F55.-)
  • immunodeficiency due to drugs (D84.821)
  • drug reaction and poisoning affecting newborn (P00-P96)
  • pathological drug intoxication (inebriation) (F10-F19)

Code First

Underlying conditions that must be sequenced before this code.

  • Code first, for adverse effects, the nature of the adverse effect, such as:
  • adverse effect NOS (T88.7)
  • aspirin gastritis (K29.-)
  • blood disorders (D56-D76)
  • contact dermatitis (L23-L25)
  • dermatitis due to substances taken internally (L27.-)
  • nephropathy (N14.0-N14.2)

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code(s) to specify:
  • manifestations of poisoning
  • underdosing or failure in dosage during medical and surgical care (Y63.6, Y63.8-Y63.9)
  • underdosing of medication regimen (Z91.12-, Z91.13-)

Frequently Asked Questions (FAQ) & Clinical Guidance

Can T45.95 be billed directly?

No. T45.95 (Adverse effect of unspecified primarily systemic and hematological agent) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

Does T45.95 require a 7th character?

Yes. The appropriate 7th character is to be added to each code from category T45.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to T45.95 in its code family, with their registry titles.

  • T45.93XS — Poisoning by unspecified primarily systemic and hematological agent, assault, sequela
  • T45.94 — Poisoning by unspecified primarily systemic and hematological agent, undetermined
  • T45.94XA — Poisoning by unspecified primarily systemic and hematological agent, undetermined, initial encounter
  • T45.94XD — Poisoning by unspecified primarily systemic and hematological agent, undetermined, subsequent encounter
  • T45.94XS — Poisoning by unspecified primarily systemic and hematological agent, undetermined, sequela
  • T45.95XA — Adverse effect of unspecified primarily systemic and hematological agent, initial encounter
  • T45.95XD — Adverse effect of unspecified primarily systemic and hematological agent, subsequent encounter
  • T45.95XS — Adverse effect of unspecified primarily systemic and hematological agent, sequela
  • T45.96 — Underdosing of unspecified primarily systemic and hematological agent
  • T45.96XA — Underdosing of unspecified primarily systemic and hematological agent, initial encounter

View all codes in the T45 family

Associated Substances (2)

Substances from the official ICD-10-CM Table of Drugs and Chemicals that map to this code.

  • Hematological agent
  • Systemic drug