2025 ICD-10-CM code T38.5X6A
Underdosing of other estrogens and progestogens, initial encounter.
Medical necessity is established by the clinical need to evaluate and manage the potential consequences of underdosing estrogens and progestogens. The provider should document the clinical findings supporting the need for the encounter.
- T36-T50: Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances
In simple words: The patient took a lower dose of estrogen and progestogen hormones than prescribed, and this is their first visit for this issue.
Underdosing of other estrogens and progestogens, initial encounter. This code is used when a patient has taken a smaller dose of other estrogens and progestogens than prescribed or instructed, and this is their first visit for this issue.
Example 1: A patient presents to their physician's office after realizing they have been taking only one of their prescribed two estrogen pills daily for the past week. This is their initial visit for this issue., A patient is seen in the emergency room after unintentionally missing several doses of their prescribed progesterone. This is the first time they've sought medical attention for this underdosing., A patient calls their doctor's office concerned because they mistakenly took a lower dose of their estrogen patch than prescribed. They schedule an appointment for the next day, which is their initial visit for this issue.
Documentation should support the underdosing of the specific estrogen or progestogen, including the prescribed dosage and the dosage actually taken. The documentation should also indicate that this is the initial encounter for this underdosing event.
- Specialties:Endocrinology, Obstetrics/Gynecology, Family Medicine, Internal Medicine, Emergency Medicine
- Place of Service:Office, Home, Telehealth Provided in Patient’s Home, Telehealth Provided Other than in Patient’s Home, Emergency Room - Hospital, Inpatient Hospital, Outpatient Hospital