ICD-10-CM Diagnosis Code T36.3X5A - Adverse effect of macrolides, initial encounter (original) (raw)

ICD List 2025-2026 Edition

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6. 2026 ICD-10-CM Code T36.3X5A

Adverse effect of macrolides, initial encounter

ICD-10-CM Code:

T36.3X5A

ICD-10 Code for:

Adverse effect of macrolides, initial encounter

Is Billable?

Yes - Valid for Submission

Chronic Condition Indicator: [1]

Not chronic

Code Navigator:

T36.3X5A is a billable diagnosis code used to specify a medical diagnosis of adverse effect of macrolides, initial 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.

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.

T36.3X5A is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like adverse effect of macrolides. According to ICD-10-CM Guidelines an "initial encounter" doesn't necessarily means "initial visit". The 7th character should be used when the patient is undergoing active treatment regardless if new or different providers saw the patient over the course of a treatment. The appropriate 7th character codes should also be used even if the patient delayed seeking treatment for a condition.

1. Code Information
2. Approximate Synonyms
3. Clinical Classification
4. Clinical Information
5. Coding Guidelines
6. Tabular List of Diseases and Injuries
7. Code Edits
8. Diagnostic Related Groups Mapping
9. Convert to ICD-9 Code
10. Table of Drugs and Chemicals
11. Patient Education
12. Other Codes Used Similar Conditions
13. Code History

• Injury, poisoning and certain other consequences of external causes
  S00–T88
  • Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances
    T36-T50
    * Poisoning by, adverse effect of and underdosing of systemic antibiotics
    T36

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 oleandomycin
• Azithromycin adverse reaction
• Clarithromycin adverse reaction
• Erythromycin adverse reaction
• Macrolide adverse reaction
• Spiramycin 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: INJ028

Inpatient Default: X - Not applicable.

Outpatient Default: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

• Azithromycin

a semi-synthetic macrolide antibiotic structurally related to erythromycin. it has been used in the treatment of mycobacterium avium intracellulare infections, toxoplasmosis, and cryptosporidiosis.

• Josamycin

a macrolide antibiotic from streptomyces narbonensis. the drug has antimicrobial activity against a wide spectrum of pathogens.

• Kitasamycin

a macrolide antibiotic produced by streptomyces kitasatoensis. the drug has antimicrobial activity against a wide spectrum of pathogens.

• Oleandomycin

antibiotic macrolide produced by streptomyces antibioticus.

• Pristinamycin

an antibiotic mixture originally isolated from streptomyces pristinaspiralis. it is a mixture of compounds from streptogramin group a: pristinamycin iia and iib and from streptogramin group b: pristinamycin ia, pristinamycin ib, pristinamycin ic.

• Streptogramin A

a specific streptogramin group a antibiotic produced by streptomyces graminofaciens and other bacteria.

• Streptogramin B

a specific streptogramin group b antibiotic produced by streptomyces graminofaciens and other bacteria.

• Roxithromycin

semisynthetic derivative of erythromycin. it is concentrated by human phagocytes and is bioactive intracellularly. while the drug is active against a wide spectrum of pathogens, it is particularly effective in the treatment of respiratory and genital tract infections.

• Spiramycin

a macrolide antibiotic produced by streptomyces ambofaciens. the drug is effective against gram-positive aerobic pathogens, n. gonorrhoeae, and staphylococci. it is used to treat infections caused by bacteria and toxoplasma gondii.

• Troleandomycin

a macrolide antibiotic that is similar to erythromycin.

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.

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: 995.29

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: E930.3

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 T36.3X5 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.

[Learn More in MedlinePlus]

• 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.

• Previous Code: T36.3X5

• Parent Code: T36.3X5

• Next Code: T36.3X5D