2025 ICD-10-CM code T88.7
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Injury - Other complications of surgical and medical care, not elsewhere classified Injury, poisoning and certain other consequences of external causes (S00-T88) Feed
Unspecified adverse effect of drug or medicament.
Modifiers may be applicable depending on the circumstances of the encounter and the additional codes used.
Medical necessity is established by the presence of symptoms suggestive of an adverse drug reaction requiring medical attention.Further investigation may be necessary to determine the specific cause and appropriate treatment.
The clinical responsibility depends on the specific adverse effect and the physician's role in managing the patient.It could involve the prescribing physician, a hospitalist, or other relevant specialist, depending on the context.
- Injury, poisoning and certain other consequences of external causes (S00-T88)
- T88 - Other complications of surgical and medical care, not elsewhere classified
In simple words: This code is used when someone has a side effect from a medicine, but the exact side effect or the medicine itself isn't known.
This code represents an unspecified adverse effect resulting from the use of a drug or medicament.It is used when a specific adverse effect cannot be identified or when the drug causing the adverse reaction is unknown.Additional codes should be used to specify the manifestation(s) of the adverse effect and to identify the drug involved (using codes T36-T50 with 5th or 6th character = 5), if known.
Example 1: A patient presents with an unexplained rash after starting a new medication. The exact medication and specific type of rash are unknown, so T88.7 is used., A patient experiences generalized malaise and fatigue following a course of antibiotics. The symptoms are attributed to the medication, but the precise nature of the adverse reaction is undefined. T88.7 is used in conjunction with codes describing the symptoms., A patient is admitted to the hospital with a severe allergic reaction to an unknown medication. While investigations are ongoing to identify the drug and specify the allergic reaction type, T88.7 is used as the primary diagnosis to reflect the current understanding.
Detailed patient history, including medication list, onset and progression of symptoms, physical examination findings, and results of relevant investigations (e.g., allergy testing, blood work).
** Always ensure proper documentation to support the use of this code and consider using additional codes to fully describe the adverse reaction and contributing factors. This code should be used cautiously and only when more specific codes are not applicable.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:All specialties
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Emergency Room, Urgent Care, Other Place of Service