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2025 ICD-10-CM code T36.9

Poisoning by, adverse effect of, and underdosing of unspecified systemic antibiotic.

Additional codes should be used to specify the nature of the adverse event (e.g., allergic reaction, toxic effect, organ damage) and the specific antibiotic, if known.A seventh character (A, D, or S) is required to specify the encounter type.

Medical necessity is established when the use of the systemic antibiotic was deemed appropriate for a bacterial infection or other indicated condition.Documentation should demonstrate that the adverse effect or poisoning resulted from the administration of the antibiotic and that appropriate treatment was administered.

The clinical responsibility falls upon the physician or healthcare provider who prescribed and/or administered the antibiotic.This includes proper diagnosis, medication reconciliation, patient education, monitoring for adverse reactions, and management of complications arising from the poisoning, adverse effect, or underdosing.

IMPORTANT:More specific codes within the T36-T50 range should be used if the specific antibiotic and the nature of the adverse effect are known.Additional codes may be required to specify manifestations of poisoning or underdosing.

In simple words: This code is used when someone experiences a problem (poisoning, side effect, or too little medicine) from taking a type of antibiotic medicine that isn't specifically named.It may happen by accident, on purpose, or be a mistake with the dose.

This ICD-10-CM code classifies instances of poisoning, adverse effects, or underdosing resulting from the use of unspecified systemic antibiotics.It encompasses various scenarios, including accidental ingestion, intentional self-harm, medication errors, and adverse reactions to correctly administered antibiotics.The code requires additional codes to specify the nature of the adverse effect (e.g., allergic reaction, organ damage) and the specific antibiotic involved, if known.Appropriate seventh characters (A, D, or S) should be appended to indicate the encounter type (initial, subsequent, or sequela).

Example 1: A patient is admitted to the hospital after accidentally ingesting a large quantity of an unspecified systemic antibiotic. The patient experiences nausea, vomiting, and diarrhea., A patient develops an allergic reaction (rash, hives, itching) to an unspecified systemic antibiotic prescribed for a bacterial infection. The reaction is treated with antihistamines and corticosteroids., A patient experiences a severe adverse effect (e.g., anaphylaxis) due to an unspecified systemic antibiotic. This necessitates immediate emergency care, including epinephrine administration and respiratory support.

Detailed medication reconciliation report;Complete description of adverse events, including timeline, symptoms, treatment administered, and patient response; All laboratory test results related to the adverse reaction or poisoning;Relevant clinical findings from the physical examination; Physician's notes documenting the diagnosis, treatment plan, and follow-up care;Supporting evidence of medical necessity.

** This code is used when the specific systemic antibiotic involved cannot be identified.It's crucial to document as much detail as possible about the antibiotic and the nature of the adverse effect to ensure proper coding.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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