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T88.6 ICD-10-CM Code: Anaphylactic reaction due to adverse effect of correct drug or medicament properly administered

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

Coding at a Glance

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for T88.6 in the official ICD-10-CM tabular list, quoted as published.

Notes without a marker are published on T88.6 itself; “inherited from” names the category or block whose note applies here.

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Anaphylactic shock due to adverse effect of correct drug or medicament properly administered
  • Anaphylactoid reaction NOS

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)

Source: inherited from T80-T88

7th Character Guide

"The appropriate 7th character is to be added to each code from category T88"

  • A — initial encounter
  • D — subsequent encounter
  • S — sequela

How the encounter character is assigned. “Initial encounter” means the patient is receiving active treatment for the condition — it is not limited to the first visit, and a different or new provider giving active treatment still assigns it. “Subsequent encounter” covers care during the healing or recovery phase after active treatment. “Sequela” is for complications or conditions that arise as a direct result of the original condition.

ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.19.a (paraphrased by MedCoder).

Variant codes in this family

T88.6XXA, T88.6XXD, T88.6XXS

Character meanings are CMS's official 7th-character extensions for this family, as carried in each variant code's official description; variant codes are registry rows. The explanation of how the encounter character is assigned is MedCoder editorial, distinct from the official content above it.

Coder workflow for T88.6

MedCoder structured workflow — derived from this code’s own official record

Before you code T88.6

  1. T88.6 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewT88.6XXA, T88.6XXD, T88.6XXS

    See the relationships section · Guide: How to choose an ICD-10-CM code →

  2. A 7th character is required in this family. Confirm the documented encounter: initial (active treatment), subsequent (healing or recovery phase), or sequela. T88.6 is not valid without one. “Initial” means active treatment, not the first visit (Guidelines I.C.19.a).

    See the 7th Character Guide · Guide: 7th characters: initial, subsequent, sequela →

  3. T88.6’s title joins a condition with an associated condition or complication. Confirm each component is documented. Where the classification presumes the link through the “with” convention, only a provider statement that the conditions are unrelated defeats it. A combination code is assigned only when it fully identifies the documented conditions; a required second code for the stage, type or manifestation is still reported when the notes ask for it (Guidelines I.B.9, I.A.15).

    Guide: Combination codes →

  4. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with T88.6. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support one of the more specific codes beneath T88.6?
    Yes → Select that code and continue the checks below on its own page.
    No → T88.6 cannot be reported as written; query for the specificity its subcategory needs.

    ReviewT88.6XXA, T88.6XXD, T88.6XXS

  2. Does the documentation support a condition named in T88.6’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewT80.5, T78.0

  3. Is the encounter phase documented — active treatment, healing or recovery, or a sequela?
    Yes → Assign the matching 7th character; the variant codes are in the 7th Character Guide.
    No → The code is invalid without its 7th character — query for the missing element.

Consider T88.6. Then work the Use Additional Code note, and confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Encounter type
Active treatment, healing or recovery phase, or sequela — the basis of the 7th character (Guidelines I.C.19.a).
The associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).
The conditions the Use Additional Code note names
Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.

Official instructions as workflow

  • Excludes1 — check before selecting T88.6(2 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with T88.6: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareT80.5, T78.0

    See the official tabular notes · Guidelines I.A.12.a

  • Excludes2 — not part of T88.6(31 notes)

    Coding workflow: The conditions named in this note are not included in T88.6. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareT80, T81, O74, O29, O89, O75.4

    See the official tabular notes · Guidelines I.A.12.b

  • Use Additional Code — after identifying T88.6(3 notes)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with T88.6 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition T88.6 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewT80.5, T78.0

Documentation: The patient returns during the healing or recovery phase after active treatment of the same condition.

Coding question: Which 7th character applies?

Path: Review the official 7th-character definitions for this family in the 7th Character Guide.

Reason: “Initial encounter” means active treatment, not the first visit; care during recovery takes “subsequent encounter”, and a complication arising from the original condition takes “sequela” (Guidelines I.C.19.a).

Documentation: Only one of the components this code’s title joins is documented.

Coding question: Is T88.6 supported?

Path: Review the code for the documented component on its own.

Reason: A combination code is assigned only when it fully identifies the documented conditions; otherwise the documented component takes its own code (Guidelines I.B.9).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Anaphylactic reaction due to adverse effect of correct drug or medicament properly administered is a non-billable ICD-10-CM category code (T88.6). A more specific billable subcode must be selected for claims submission.

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (3)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. A 7th character applies in this family. Confirm the documented encounter matches the character assigned. See the official 7th-character definitions and this code’s variants
  2. 3 Use Additional Code instructions — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
  3. 2 Excludes1 entries — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
  4. 31 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

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

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name T88.6 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 5 Excludes1 notes across 2 chapters: R57 — Shock, not elsewhere classified, T78.2 — Anaphylactic shock, unspecified, T79.4 — Traumatic shock, T80.5 — Anaphylactic reaction due to serum, T81.1 — Postprocedural shock.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 2 Excludes2 notes: T78 — Adverse effects, not elsewhere classified (via T88.-), T79 — Certain early complications of trauma, not elsewhere classified (via T88.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Related Codes

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Allergy, allergic”, “Shock”; these codes share that main term but sit in a different category of the Tabular List.

T79.4 — Traumatic shock (traumatic), T79.5 — Traumatic anuria (kidney, traumatic), T80.51 — Anaphylactic reaction due to administration of blood and blood products (anaphylactic, serum, blood and blood products), T80.52 — Anaphylactic reaction due to vaccination (anaphylactic, immunization), T80.59 — Anaphylactic reaction due to other serum (anaphylactic, serum), T80.69 — Other serum reaction due to other serum (serum), T81.10 — Postprocedural shock unspecified (surgical), T81.11 — Postprocedural cardiogenic shock (postprocedural, cardiogenic), T81.12 — Postprocedural septic shock (postprocedural, septic), T81.19 — Other postprocedural shock (pleural), Z71.3 — Dietary counseling and surveillance (food NEC, dietary counseling and surveillance), Z91.010 — Allergy to peanuts (food NEC, status, peanuts), Z91.0110 — Allergy to milk products, unspecified (milk protein), Z91.0111 — Allergy to milk products with tolerance to baked milk (milk protein, with, tolerance to baked milk), Z91.0112 — Allergy to milk products with reactivity to baked milk (milk protein, with, reactivity to baked milk), Z91.0120 — Allergy to eggs, unspecified (food NEC, status, eggs), Z91.0121 — Allergy to eggs with tolerance to baked egg (food NEC, status, eggs, with, tolerance to baked egg), Z91.0122 — Allergy to eggs with reactivity to baked egg (food NEC, status, eggs, with, reactivity to baked egg), Z91.013 — Allergy to seafood (food NEC, status, seafood), Z91.014 — Allergy to mammalian meats (food NEC, status, lamb), +66 more

Contextual Map

Every relationship of T88.6 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.

Run T88.6 with these 8 related codes in Claim Check

Hierarchy

Excludes1

Referenced by Excludes1 notes

  • R57 — Shock, not elsewhere classified[Excludes1]: “anaphylactic shock due to adverse effect of correct drug or medicament properly administered (T88.6)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • T78.2 — Anaphylactic shock, unspecified[Excludes1]: “anaphylactic reaction or shock due to adverse effect of correct medicinal substance properly administered (T88.6)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • T79.4 — Traumatic shock[Excludes1]: “anaphylactic shock due to correct medicinal substance properly administered (T88.6)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • T80.5 — Anaphylactic reaction due to serum[Excludes1]: “anaphylactic reaction or shock due to adverse effect of correct medicinal substance properly administered (T88.6)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • T81.1 — Postprocedural shock[Excludes1]: “anaphylactic shock due to correct substance properly administered (T88.6)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes2 notes

Index entries

  • Allergy, allergic (reaction) (to), shock (anaphylactic), due to, adverse effect of correct medicinal substance properly administered[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Shock, anaphylactic, due to drug or medicinal substance, correct substance properly administered[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Shock, drug, due to correct substance properly administered[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (40)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Common coding questions

Can T88.6 be billed directly?

No. T88.6 (Anaphylactic reaction due to adverse effect of correct drug or medicament properly administered) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

Does T88.6 require a 7th character?

Yes. The appropriate 7th character is to be added to each code from category T88.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Anaphylactic reaction due to adverse effect of correct drug or medicament properly administered

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to T88.6 in its code family, with their registry titles.

View all codes in the T88 family