ICD-10-CM Diagnosis Code T36.1X5S - Adverse effect of cephalosporins and other beta-lactam antibiotics, sequela (original) (raw)
ICD List 2025-2026 Edition
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- 2026 ICD-10-CM Code T36.1X5S
Adverse effect of cephalosporins and other beta-lactam antibiotics, sequela
ICD-10-CM Code:
T36.1X5S
ICD-10 Code for:
Advrs effect of cephalospor/oth beta-lactm antibiot, sequela
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Not chronic
Code Navigator:
T36.1X5S is a billable diagnosis code used to specify a medical diagnosis of adverse effect of cephalosporins and other beta-lactam antibiotics, sequela. 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.
T36.1X5S is a sequela code, includes a 7th character and should be used for complications that arise as a direct result of a condition like adverse effect of cephalosporins and other beta-lactam antibiotics. According to ICD-10-CM Guidelines a "sequela" code should be used for chronic or residual conditions that are complications of an initial acute disease, illness or injury. The most common sequela is pain. Usually, two diagnosis codes are needed when reporting sequela. The first code describes the nature of the sequela while the second code describes the sequela or late effect.
- 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 clavulanic acid and/or ticarcillin
- Adverse reaction to piperacillin and/or tazobactam
- Aztreonam adverse reaction
- Beta lactam adverse reaction
- Carbapenem adverse reaction
- Cefaclor adverse reaction
- Cefadroxil adverse reaction
- Cefixime adverse reaction
- Cefodizime adverse reaction
- Cefotaxime adverse reaction
- Cefoxitin adverse reaction
- Cefpirome adverse reaction
- Cefpodoxime adverse reaction
- Cefsulodin adverse reaction
- Ceftazidime adverse reaction
- Ceftibuten adverse reaction
- Ceftizoxime adverse reaction
- Ceftriaxone adverse reaction
- Cefuroxime adverse reaction
- Cephalexin adverse reaction
- Cephalosporin adverse reaction
- Cephalothin adverse reaction
- Cephamandole adverse reaction
- Cephamycin adverse reaction
- Cephazolin adverse reaction
- Cephradine adverse reaction
- First generation cephalosporin adverse reaction
- Fourth generation cephalosporin adverse reaction
- Latamoxef adverse reaction
- Monobactam adverse reaction
- Second generation cephalosporin adverse reaction
- Third generation cephalosporin adverse reaction
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: INJ075
Inpatient Default: X - Not applicable.
Outpatient Default: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Aztreonam
a monocyclic beta-lactam antibiotic originally isolated from chromobacterium violaceum. it is resistant to beta-lactamases and is used in gram-negative infections, especially of the meninges, bladder, and kidneys. it may cause a superinfection with gram-positive organisms.
Cefaclor
semisynthetic, broad-spectrum antibiotic derivative of cephalexin.
Cefadroxil
long-acting, broad-spectrum, water-soluble, cephalexin derivative.
Cefamandole
semisynthetic wide-spectrum cephalosporin with prolonged action, probably due to beta-lactamase resistance. it is used also as the nafate.
Cefatrizine
orally active semisynthetic cephalosporin antibiotic with broad-spectrum activity.
Cefazolin
a semisynthetic cephalosporin analog with broad-spectrum antibiotic action due to inhibition of bacterial cell wall synthesis. it attains high serum levels and is excreted quickly via the urine.
Cefixime
a third-generation cephalosporin antibiotic that is stable to hydrolysis by beta-lactamases.
Cefmenoxime
a cephalosporin antibiotic that is administered intravenously or intramuscularly. it is active against most common gram-positive and gram-negative microorganisms, is a potent inhibitor of enterobacteriaceae, and is highly resistant to hydrolysis by beta-lactamases. the drug has a high rate of efficacy in many types of infection and to date no severe side effects have been noted.
Cefmetazole
a semisynthetic cephamycin antibiotic with a broad spectrum of activity against both gram-positive and gram-negative microorganisms. it has a high rate of efficacy in many types of infection and to date no severe side effects have been noted.
Cefonicid
a second-generation cephalosporin administered intravenously or intramuscularly. its bactericidal action results from inhibition of cell wall synthesis. it is used for urinary tract infections, lower respiratory tract infections, and soft tissue and bone infections.
Cefoperazone
semisynthetic broad-spectrum cephalosporin with a tetrazolyl moiety that is resistant to beta-lactamase. it may be used to treat pseudomonas infections.
Cefotaxime
semisynthetic broad-spectrum cephalosporin.
Cefotetan
a semisynthetic cephamycin antibiotic that is administered intravenously or intramuscularly. the drug is highly resistant to a broad spectrum of beta-lactamases and is active against a wide range of both aerobic and anaerobic gram-positive and gram-negative microorganisms.
Cefotiam
one of the cephalosporins that has a broad spectrum of activity against both gram-positive and gram-negative microorganisms.
Cefoxitin
a semisynthetic cephamycin antibiotic resistant to beta-lactamase.
Cefsulodin
a pyridinium-substituted semisynthetic, broad-spectrum antibacterial used especially for pseudomonas infections in debilitated patients.
Ceftazidime
semisynthetic, broad-spectrum antibacterial derived from cephaloridine and used especially for pseudomonas and other gram-negative infections in debilitated patients.
Ceftizoxime
a semisynthetic cephalosporin antibiotic which can be administered intravenously or by suppository. the drug is highly resistant to a broad spectrum of beta-lactamases and is active against a wide range of both aerobic and anaerobic gram-positive and gram-negative organisms. it has few side effects and is reported to be safe and effective in aged patients and in patients with hematologic disorders.
Ceftriaxone
a broad-spectrum cephalosporin antibiotic and cefotaxime derivative with a very long half-life and high penetrability to meninges, eyes and inner ears.
Cefuroxime
broad-spectrum cephalosporin antibiotic resistant to beta-lactamase. it has been proposed for infections with gram-negative and gram-positive organisms, gonorrhea, and haemophilus.
Cephalexin
a semisynthetic cephalosporin antibiotic with antimicrobial activity similar to that of cephaloridine or cephalothin, but somewhat less potent. it is effective against both gram-positive and gram-negative organisms.
Cephalosporinase
a cephalosporin antibiotic.
Cephaloglycin
a cephalorsporin antibiotic.
Cephaloridine
a cephalosporin antibiotic.
Cephalosporins
a group of broad-spectrum antibiotics first isolated from the mediterranean fungus acremonium. they contain the beta-lactam moiety thia-azabicyclo-octenecarboxylic acid also called 7-aminocephalosporanic acid.
First Generation Cephalosporins
cephalosporin agents with excellent coverage against gram-positive cocci, such as staphylococcus and streptococcus. they have some activity against the gram-negative bacteria, but in general, gram-negative activity is decreased compared to 2nd, 3rd, and 4th generation cephalosporins.
Second Generation Cephalosporins
agents with less activity against gram-positive cocci than first generation cephalosporins but have increased activity against gram-negative bacilli.
Third Generation Cephalosporins
agents that are structurally similar to other cephalosporins but have a broader spectrum of activity against bacteria than the first and second generation cephalosporins. these agents cover more resistant streptococcus, staphylococcus, gram-positive anaerobes, and more resistant strains of haemophilus, neisseria, proteus, escherichia coli, and klebsiella (hnpek).
Cephalothin
a cephalosporin antibiotic.
Cephradine
a semi-synthetic cephalosporin antibiotic.
Clavulanic Acid
a beta-lactam antibiotic produced by the actinobacterium streptomyces clavuligerus. it is a suicide inhibitor of bacterial beta-lactamase enzymes. administered alone, it has only weak antibacterial activity against most organisms, but given in combination with other beta-lactam antibiotics it prevents antibiotic inactivation by microbial lactamase.
Clavulanic Acids
acids, salts, and derivatives of clavulanic acid (c8h9o5n). they consist of those beta-lactam compounds that differ from penicillin in having the sulfur of the thiazolidine ring replaced by an oxygen. they have limited antibacterial action, but block bacterial beta-lactamase irreversibly, so that similar antibiotics are not broken down by the bacterial enzymes and therefore can exert their antibacterial effects.
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.
T36.1X5S 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: 909.5
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.
ICD-9-CM: E930.5
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 T36.1X5 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:
Antibiotics
What are antibiotics?
Antibiotics are medicines that fight bacterial infections in people and animals. They work by killing the bacteria or by making it hard for the bacteria to grow and multiply.
Antibiotics can be taken in different ways:
- Orally (by mouth). This could be pills, capsules, or liquids.
- Topically. This might be a cream, spray, or ointment that you put on your skin. It could also be eye ointment, eye drops, or ear drops.
- Through an injection or intravenously (IV). This is usually for more serious infections.
What do antibiotics treat?
Antibiotics only treat certain bacterial infections, such as strep throat, urinary tract infections, and E. coli.
You may not need to take antibiotics for some bacterial infections. For example, you might not need them for many sinus infections or some ear infections. Taking antibiotics when they're not needed won't help you, and they can have side effects. Your health care provider can decide the best treatment for you when you're sick. Don't ask your provider to prescribe an antibiotic for you.
Do antibiotics treat viral infections?
Antibiotics do not work on viral infections. For example, you shouldn't take antibiotics for:
- Colds and runny noses, even if the mucus is thick, yellow, or green
- Most sore throats (except strep throat)
- Flu
- Most cases of bronchitis
What are the side effects of antibiotics?
The side effects of antibiotics range from minor to very severe. Some of the common side effects include:
- Rash
- Nausea
- Diarrhea
- Yeast infections
More serious side effects can include:
- C. diff infections, which cause diarrhea that can lead to severe colon damage and sometimes even death
- Severe and life-threatening allergic reactions
- Antibiotic resistance infections
Call your health care provider if you develop any side effects while taking your antibiotic.
Why is it important to take antibiotics only when they're needed?
You should only take antibiotics when they are needed because they can cause side effects and can contribute to antibiotic resistance. Antibiotic resistance happens when the bacteria change and become able to resist the effects of an antibiotic. This means that the bacteria continue to grow.
How do I use antibiotics correctly?
When you take antibiotics, it is important that you take them responsibly:
- Always follow the directions carefully. Finish your medicine even if you feel better. If you stop taking them too soon, some bacteria may survive and re-infect you.
- Don't save your antibiotics for later.
- Don't share your antibiotic with others.
- Don't take antibiotics prescribed for someone else. This may delay the best treatment for you, make you even sicker, or cause side effects.
Centers for Disease Control and Prevention
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.