2025 ICD-10-CM code T45.1
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Poisoning - Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances Injury, poisoning and certain other consequences of external causes (S00-T88) Feed
Poisoning by, adverse effect of, and underdosing of antineoplastic and immunosuppressive drugs.
Medical necessity for coding T45.1 is established when a patient experiences an adverse reaction to an antineoplastic or immunosuppressive medication. This requires evidence of the administration of the medication, a direct relationship between the drug and the symptoms, and appropriate clinical management of the adverse effect.
The clinical responsibility for this code falls upon the physician or healthcare provider managing the patient's treatment and monitoring for adverse drug reactions. This includes documenting the type of antineoplastic/immunosuppressive drug used, the dosage, the route of administration, and the timeline of events. The physician will also need to code any resulting adverse effects of the medication.
In simple words: This code is used when someone gets sick or has a bad reaction from cancer drugs or drugs that weaken the immune system. This could be from taking too much, too little, or an accidental exposure.
This code classifies poisoning, adverse effects, or underdosing resulting from the use of antineoplastic (cancer-treating) and immunosuppressive (immune system-suppressing) drugs.It encompasses unintentional or accidental exposures, as well as adverse reactions stemming from appropriate administration.The specific drug should be documented elsewhere in the medical record. Excludes poisoning by tamoxifen (T38.6).
Example 1: A 65-year-old patient receiving chemotherapy for lung cancer experiences severe nausea and vomiting after their first cycle of treatment.T45.1 is used to code the adverse effect of the antineoplastic drug. Additional codes would specify the nausea and vomiting., A 50-year-old organ transplant recipient develops a severe infection due to immunosuppressant medication.T45.1 is assigned, along with codes for the type of infection. , A 30-year-old patient accidentally ingests a large quantity of an immunosuppressant medication. This would be coded with T45.1 and additional codes detailing the symptoms and severity of the poisoning.
Complete and accurate documentation is essential. This should include the specific antineoplastic or immunosuppressive drug administered (name, dosage, route, frequency, and dates), the onset and duration of symptoms, laboratory findings, and any treatment provided. The clinical notes should clearly indicate a causal relationship between the medication and the adverse effect.
** Always cross-reference with other relevant codes to ensure complete and accurate billing. For example,additional codes might be necessary to detail the specific type and severity of the adverse reaction.
- Payment Status: Active
- Specialties:Oncology, Hematology, Transplant Surgery, Rheumatology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Physician's Office