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T80.52XA ICD-10-CM Code: Anaphylactic reaction due to vaccination, initial encounter

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 791 — PREMATURITY WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 915 — ALLERGIC REACTIONS WITH MCC (MDC 21)
  • MS-DRG 916 — ALLERGIC REACTIONS WITHOUT MCC (MDC 21)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Official Registry Overview & Definition

Anaphylactic reaction due to vaccination, initial encounter is a billable ICD-10-CM diagnosis code (T80.52A).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for T80.52XA in the official ICD-10-CM tabular list.

Includes

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

  • complications following perfusion

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Excludes2 — Not Included Here

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

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
  • Use additional code(s) to identify the specified condition resulting from the complication
  • Use additional code to identify devices involved and details of circumstances (Y62-Y82)

Frequently Compared Codes

The official Excludes notes on T80.52XA name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

No changes recorded for this code — unchanged since the FY2016 baseline of the change ledger.

Verify Before Coding

  • CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.

Relationships & Classification

Official ICD-10-CM tabular notes on other codes that name T80.52XA or its code family.

6 Excludes1 notes across 2 chapters: R57 (via T80.5.-), T78.2 (via T80.5.-), T79.4 (via T80.5.-), T81.1 (via T80.5.-), T88.6 (via T80.5.-), T88.7 (via T80.-).

6 Excludes2 notes: T45.8 (via T80.-), T78 (via T80.-), T79 (via T80.-), T81 (via T80.-), T88 (via T80.-), T88.1 (via T80.5.-).

Potential MS-DRG Relationships (FY2026)

CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 6 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 4 MS-DRGs: DRG 791 (MDC 15), DRG 793 (MDC 15), DRG 915 (MDC 21), DRG 916 (MDC 21).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):INJ037 — Complication of other surgical or medical care, injury, initial encounter (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Contextual Map

Every relationship of T80.52XA in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

  • S00-T88 — Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) (S00-T88) [Hierarchy]
  • T80-T88 — Complications of surgical and medical care, not elsewhere classified [Hierarchy]

Referenced by Excludes1 notes

  • R57 — Shock, not elsewhere classified [Excludes1](via T80.5.-): “anaphylactic shock due to serum (T80.5-)” · check together
  • T78.2 — Anaphylactic shock, unspecified [Excludes1](via T80.5.-): “anaphylactic reaction or shock due to serum (T80.5-)” · check together
  • T79.4 — Traumatic shock [Excludes1](via T80.5.-): “anaphylactic shock due to serum (T80.5-)” · check together
  • T81.1 — Postprocedural shock [Excludes1](via T80.5.-): “anaphylactic shock due to serum (T80.5-)” · check together
  • T88.6 — Anaphylactic reaction due to adverse effect of correct drug or medicament properly administered [Excludes1](via T80.5.-): “anaphylactic reaction due to serum (T80.5-)” · check together
  • T88.7 — Unspecified adverse effect of drug or medicament [Excludes1](via T80.-): “specified adverse effects of drugs and medicaments (A00-R94 and T80-T88.6, T88.8)” · check together

Referenced by Excludes2 notes

  • T45.8 — Poisoning by, adverse effect of and underdosing of other primarily systemic and hematological agents [Excludes2](via T80.-): “transfusion reactions (T80.-)” · check together
  • T78 — Adverse effects, not elsewhere classified [Excludes2](via T80.-): “complications of surgical and medical care NEC (T80-T88)” · check together
  • T79 — Certain early complications of trauma, not elsewhere classified [Excludes2](via T80.-): “complications occurring during or following medical procedures (T80-T88)” · check together
  • T81 — Complications of procedures, not elsewhere classified [Excludes2](via T80.-): “complications following infusion, transfusion and therapeutic injection (T80.-)” · check together
  • T88 — Other complications of surgical and medical care, not elsewhere classified [Excludes2](via T80.-): “complication following infusion, transfusion and therapeutic injection (T80.-)” · check together
  • T88.1 — Other complications following immunization, not elsewhere classified [Excludes2](via T80.5.-): “anaphylactic shock due to serum (T80.5-)” · check together

Clinical classification (CCSR)

  • INJ037 — Complication of other surgical or medical care, injury, initial encounter [CCSR]

Potential MS-DRG

  • CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”
  • DRG 791 — PREMATURITY WITH MAJOR PROBLEMS [MS-DRG]: “PREMATURITY WITH MAJOR PROBLEMS (MDC 15)”
  • DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS [MS-DRG]: “FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)”
  • DRG 915 — ALLERGIC REACTIONS WITH MCC [MS-DRG]: “ALLERGIC REACTIONS WITH MCC (MDC 21)”
  • DRG 916 — ALLERGIC REACTIONS WITHOUT MCC [MS-DRG]: “ALLERGIC REACTIONS WITHOUT MCC (MDC 21)”

MDC crossing · procedures (32029)

  • MDC 15 — Newborns and Other Neonates with Conditions Originating in Perinatal Period [MDC crossing]: “Newborns and Other Neonates with Conditions Originating in Perinatal Period — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • MDC 21 — Injuries, Poisonings and Toxic Effects of Drugs [MDC crossing]: “Injuries, Poisonings and Toxic Effects of Drugs — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • and 32029 more

Nearest codes (40)

  • T80 — Complications following infusion, transfusion and therapeutic injection [Sibling]
  • T80.410D — Rh incompatibility with acute hemolytic transfusion reaction, subsequent encounter [Sibling]
  • T80.410S — Rh incompatibility with acute hemolytic transfusion reaction, sequela [Sibling]
  • T80.411 — Rh incompatibility with delayed hemolytic transfusion reaction [Sibling]
  • T80.411A — Rh incompatibility with delayed hemolytic transfusion reaction, initial encounter [Sibling]
  • T80.411D — Rh incompatibility with delayed hemolytic transfusion reaction, subsequent encounter [Sibling]
  • T80.411S — Rh incompatibility with delayed hemolytic transfusion reaction, sequela [Sibling]
  • T80.419 — Rh incompatibility with hemolytic transfusion reaction, unspecified [Sibling]
  • and 32 more

Frequently Asked Questions (FAQ) & Clinical Guidance

Does T80.52XA require a 7th character?

Yes. The appropriate 7th character is to be added to each code from category T80.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to T80.52XA in its code family, with their registry titles.

  • T80.51 — Anaphylactic reaction due to administration of blood and blood products
  • T80.51XA — Anaphylactic reaction due to administration of blood and blood products, initial encounter
  • T80.51XD — Anaphylactic reaction due to administration of blood and blood products, subsequent encounter
  • T80.51XS — Anaphylactic reaction due to administration of blood and blood products, sequela
  • T80.52 — Anaphylactic reaction due to vaccination
  • T80.52XD — Anaphylactic reaction due to vaccination, subsequent encounter
  • T80.52XS — Anaphylactic reaction due to vaccination, sequela
  • T80.59 — Anaphylactic reaction due to other serum
  • T80.59XA — Anaphylactic reaction due to other serum, initial encounter
  • T80.59XD — Anaphylactic reaction due to other serum, subsequent encounter

View all codes in the T80 family