ICD-10-CM Diagnosis Code T36.0X5D - Adverse effect of penicillins, subsequent encounter (original) (raw)
ICD List 2025-2026 Edition
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- 2026 ICD-10-CM Code T36.0X5D
Adverse effect of penicillins, subsequent encounter
ICD-10-CM Code:
T36.0X5D
ICD-10 Code for:
Adverse effect of penicillins, subsequent encounter
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Not chronic
Code Navigator:
T36.0X5D is a billable diagnosis code used to specify a medical diagnosis of adverse effect of penicillins, subsequent encounter. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2025 through September 30, 2026. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
This code describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.
T36.0X5D is a subsequent encounter code, includes a 7th character and should be used after the patient has completed active treatment for a condition like adverse effect of penicillins. According to ICD-10-CM Guidelines a "subsequent encounter" occurs when the patient is receiving routine care for the condition during the healing or recovery phase of treatment. Subsequent diagnosis codes are appropriate during the recovery phase, no matter how many times the patient has seen the provider for this condition. If the provider needs to adjust the patient's care plan due to a setback or other complication, the encounter becomes active again.
- Code Information
- Approximate Synonyms
- Clinical Classification
- Clinical Information
- Coding Guidelines
- Tabular List of Diseases and Injuries
- Code Edits
- Diagnostic Related Groups Mapping
- Present on Admission (POA)
- Convert to ICD-9 Code
- Table of Drugs and Chemicals
- Patient Education
- Other Codes Used Similar Conditions
- Code History
- Injury, poisoning and certain other consequences of external causes
S00–T88
The following list of clinical terms are approximate synonyms, alternative descriptions, or common phrases that might be used by patients, healthcare providers, or medical coders to describe the same condition. These synonyms and related diagnosis terms are often used when searching for an ICD-10 code, especially when the exact medical terminology is unclear. Whether you're looking for lay terms, similar diagnosis names, or common language alternatives, this list can help guide you to the correct ICD-10 classification.
- Adverse reaction to amoxicillin and/or clavulanic acid
- Adverse reaction to amoxicillin and/or clavulanic acid
- Adverse reaction to ampicillin and/or cloxacillin
- Adverse reaction to ampicillin and/or cloxacillin
- Adverse reaction to ampicillin and/or floxacillin
- Adverse reaction to ampicillin and/or floxacillin
- Adverse reaction to clavulanic acid and/or ticarcillin
- Adverse reaction to clavulanic acid and/or ticarcillin
- Adverse reaction to piperacillin and/or tazobactam
- Adverse reaction to piperacillin and/or tazobactam
- Adverse reaction to pivampicillin and/or pivmecillinam
- Allergic reaction caused by antibacterial agent
- Allergic reaction caused by antibacterial agent
- Allergic reaction caused by antiinfective agent
- Allergic reaction caused by antiinfective agent
- Allergic reaction caused by penicillin
- Allergic reaction caused by penicillin
- Amoxycillin adverse reaction
- Ampicillin adverse reaction
- Ampicillin adverse reaction
- Antipseudomonal penicillins adverse reaction
- Azlocillin adverse reaction
- Bacampicillin adverse reaction
- Benethamine penicillin adverse reaction
- Benzathine penicillin adverse reaction
- Benzylpenicillin adverse reaction
- Broad spectrum penicillins adverse reaction
- Broad spectrum penicillins adverse reaction
- Carbenicillin adverse reaction
- Carfecillin adverse reaction
- Ciclacillin adverse reaction
- Cloxacillin adverse reaction
- Drug-induced anaphylaxis
- Drug-induced angioedema-urticaria
- Epstein-Barr virus infectious mononucleosis
- Flucloxacillin adverse reaction
- Infectious mononucleosis ampicillin reaction
- Infectious mononucleosis exanthem
- Maculopapular drug eruption
- Maculopapular eruption
- Mecillinam adverse reaction
- Methicillin adverse reaction
- Mezlocillin adverse reaction
- Penicillin adverse reaction
- Penicillinase-resistant penicillins adverse reaction
- Penicillinase-sensitive penicillins adverse reaction
- Penicillin-induced anaphylaxis
- Penicillin-induced angioedema-urticaria
- Phenethicillin adverse reaction
- Phenoxymethylpenicillin adverse reaction
- Piperacillin adverse reaction
- Pivampicillin adverse reaction
- Pivmecillinam adverse reaction
- Procaine benzylpenicillin adverse reaction
- Talampicillin adverse reaction
- Temocillin adverse reaction
- Ticarcillin adverse reaction
- Urticaria medicamentosa
Clinical Classifications group individual ICD-10-CM diagnosis codes into broader, clinically meaningful categories. These categories help simplify complex data by organizing related conditions under common clinical themes.
They are especially useful for data analysis, reporting, and clinical decision-making. Even when diagnosis codes differ, similar conditions can be grouped together based on their clinical relevance. Each category is assigned a unique CCSR code that represents a specific clinical concept, often tied to a body system or medical specialty.
CCSR Code: INJ065
Inpatient Default: X - Not applicable.
Outpatient Default: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Amoxicillin
a broad-spectrum semisynthetic antibiotic similar to ampicillin except that its resistance to gastric acid permits higher serum levels with oral administration.
Amoxicillin-Potassium Clavulanate Combination
a fixed-ratio combination of amoxicillin trihydrate and potassium clavulanate.
Ampicillin
semi-synthetic derivative of penicillin that functions as an orally active broad-spectrum antibiotic.
Ampicillin Resistance
nonsusceptibility of a microbe to the action of ampicillin, a penicillin derivative that interferes with cell wall synthesis.
Pivampicillin
pivalate ester analog of ampicillin.
Talampicillin
an ester of ampicillin which is readily hydrolyzed on absorption to release ampicillin. it is well absorbed from the gastrointestinal tract resulting in a greater bioavailability of ampicillin than can be achieved with equivalent doses of ampicillin.
Azlocillin
a semisynthetic ampicillin-derived acylureido penicillin.
Carbenicillin
broad-spectrum semisynthetic penicillin derivative used parenterally. it is susceptible to gastric juice and penicillinase and may damage platelet function.
Carfecillin
the phenyl ester of carbenicillin that, upon oral administration, is broken down in the intestinal mucosa to the active antibacterial. it is used for urinary tract infections.
Penicillinase
a beta-lactamase preferentially cleaving penicillins. (dorland, 28th ed) ec 3.5.2.-.
Cloxacillin
a semi-synthetic antibiotic that is a chlorinated derivative of oxacillin.
Cyclacillin
a cyclohexylamido analog of penicillanic acid.
Dicloxacillin
one of the penicillins which is resistant to penicillinase.
Cilastatin, Imipenem Drug Combination
combination of imipenem and cilastatin that is used in the treatment of bacterial infections; cilastatin inhibits renal dehydropeptidase i to prolong the half-life and increase the tissue penetration of imipenem, enhancing its efficacy as an anti-bacterial agent.
Imipenem
semisynthetic thienamycin that has a wide spectrum of antibacterial activity against gram-negative and gram-positive aerobic and anaerobic bacteria, including many multiresistant strains. it is stable to beta-lactamases. clinical studies have demonstrated high efficacy in the treatment of infections of various body systems. its effectiveness is enhanced when it is administered in combination with cilastatin, a renal dipeptidase inhibitor.
Methicillin
one of the penicillins which is resistant to penicillinase but susceptible to a penicillin-binding protein. it is inactivated by gastric acid so administered by injection.
Methicillin Resistance
non-susceptibility of a microbe to the action of methicillin, a semi-synthetic penicillin derivative.
Methicillin-Resistant Staphylococcus aureus
a strain of staphylococcus aureus that is non-susceptible to the action of methicillin. the mechanism of resistance usually involves modification of normal or the presence of acquired penicillin binding proteins.
Mezlocillin
semisynthetic ampicillin-derived acylureido penicillin. it has been proposed for infections with certain anaerobes and may be useful in inner ear, bile, and cns infections.
Nafcillin
a semi-synthetic antibiotic related to penicillin.
Oxacillin
an antibiotic similar to flucloxacillin used in resistant staphylococci infections.
Piperacillin
semisynthetic, broad-spectrum, ampicillin derived ureidopenicillin antibiotic proposed for pseudomonas infections. it is also used in combination with other antibiotics.
Piperacillin, Tazobactam Drug Combination
an antibiotic combination product of piperacillin and tazobactam, a penicillanic acid derivative with enhanced beta-lactamase inhibitory activity, that is used for the intravenous treatment of intra-abdominal, pelvic, and skin infections and for community-acquired pneumonia of moderate severity. it is also used for the treatment of pseudomonas aeruginosa infections.
Sulbactam
a beta-lactamase inhibitor with very weak antibacterial action. the compound prevents antibiotic destruction of beta-lactam antibiotics by inhibiting beta-lactamases, thus extending their spectrum activity. combinations of sulbactam with beta-lactam antibiotics have been used successfully for the therapy of infections caused by organisms resistant to the antibiotic alone.
Sulbenicillin
semisynthetic penicillin-type antibiotic.
Ticarcillin
an antibiotic derived from penicillin similar to carbenicillin in action.
When coding an adverse effect of a drug that has been correctly prescribed and properly administered, assign the appropriate code for the nature of the adverse effect followed by the appropriate code for the adverse effect of the drug.
The appropriate 7th character is to be added to each code from block Poisoning by, adverse effect of and underdosing of systemic antibiotics (T36). Use the following options for the aplicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
The Medicare Code Editor (MCE) detects errors and inconsistencies in ICD-10-CM diagnosis coding that can affect Medicare claim validity. These Medicare code edits help medical coders and billing professionals determine when a diagnosis code is not appropriate as a principal diagnosis, does not meet coverage criteria. Use this list to verify whether a code is valid for Medicare billing and to avoid claim rejections or denials due to diagnosis coding issues.
There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.
T36.0X5D is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.
CMS POA Indicator Options and Definitions
POA Indicator: Y
Reason: Diagnosis was present at time of inpatient admission.
CMS Pays CC/MCC DRG? YES
POA Indicator: N
Reason: Diagnosis was not present at time of inpatient admission.
CMS Pays CC/MCC DRG? NO
POA Indicator: U
Reason: Documentation insufficient to determine if the condition was present at the time of inpatient admission.
CMS Pays CC/MCC DRG? NO
POA Indicator: W
Reason: Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.
CMS Pays CC/MCC DRG? YES
POA Indicator: 1
Reason: Unreported/Not used - Exempt from POA reporting.
CMS Pays CC/MCC DRG? NO
Below are the ICD-9 codes that most closely match this ICD-10 code, based on the General Equivalence Mappings (GEMs). This ICD-10 to ICD-9 crosswalk tool is helpful for coders who need to reference legacy diagnosis codes for audits, historical claims, or approximate code comparisons.
ICD-9-CM: V58.89
Approximate Flag - The approximate mapping means this ICD-10 code does not have an exact ICD-9 equivalent. The matched code is the closest available option, but it may not fully capture the original diagnosis or clinical intent.
The parent code T36.0X5 of the current diagnosis code is referenced in the Table of Drugs and Chemicals, this table contains a classification of drugs, industrial solvents, corrosive gases, noxious plants, pesticides, and other toxic agents.
According to ICD-10-CM coding guidelines it is advised to do not code directly from the Table of Drugs and Chemicals, instead always refer back to the Tabular List when doing the initial coding. Each substance in the table is assigned a code according to the poisoning classification and external causes of adverse effects. It is important to use as many codes as necessary to specify all reported drugs, medicinal or chemical substances. If the same diagnosis code describes the causative agent for more than one adverse reaction, poisoning, toxic effect or underdosing, utilize the code only once.
Filter table of drugs and chemicals:
Drug Reactions
Most of the time, medicines make our lives better. They reduce aches and pains, fight infections, and control problems such as high blood pressure or diabetes. But medicines can also cause unwanted reactions, such as drug interactions, side effects, and allergies.
What is a drug interaction?
A drug interaction is a change in the way a drug acts in the body when taken with certain other drugs, foods, or supplements or when taken while you have certain medical conditions. Examples include:
- Two drugs, such as aspirin and blood thinners
- Drugs and food, such as statins and grapefruit
- Drugs and supplements, such as gingko and blood thinners
- Drugs and medical conditions, such as aspirin and peptic ulcers
Interactions could cause a drug to be more or less effective, cause side effects, or change the way one or both drugs work.
What are side effects?
Side effects are unwanted, usually unpleasant, effects caused by medicines. Most are mild, such as a stomachache, dry mouth, or drowsiness, and go away after you stop taking the medicine. Others can be more serious. Sometimes a drug can interact with a disease that you have and cause a side effect. For example, if you have a heart condition, certain decongestants can cause you to have a rapid heartbeat.
What are drug allergies?
Drug allergies are another type of reaction. They can range from mild to life-threatening. Skin reactions, such as hives and rashes, are the most common type. Anaphylaxis, a serious allergic reaction, is less common.
How can I stay safe when taking medicines?
When you start a new prescription or over-the-counter medicine, make sure you understand how to take it correctly. Know which other medicines, foods, and supplements you need to avoid. Always talk to your health care provider or pharmacist if you have questions about your medicines.
FY 2026 - No Change, effective from 10/1/2025 through 9/30/2026
FY 2025 - No Change, effective from 10/1/2024 through 9/30/2025
FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.