Start New EnglishEspañol中文РусскийالعربيةTiếng ViệtFrançaisDeutsch한국어Tagalog Library Performance
BETA v.3.0

2025 ICD-10-CM code T78

Adverse effects, not elsewhere classified.

Always attempt to use a more specific code if possible. T78 should only be used as a last resort when the adverse effect cannot be classified using other codes within the ICD-10-CM system.Use additional codes to describe the underlying cause of the adverse effect, if known.

Medical necessity for coding T78 is established by documentation of an unexplained adverse effect requiring medical attention.The severity, duration, and impact on the patient’s health must be clearly stated to demonstrate the need for intervention.

The clinical responsibility for coding T78 depends entirely on the specific adverse effect and its cause.The physician or other qualified healthcare professional must document the nature of the adverse effect and its relationship to the exposure event to support proper coding.

IMPORTANT:Consider more specific codes if the adverse effect aligns with a defined category (e.g., allergic reactions, drug reactions).If a retained foreign body contributes to the adverse effect, code Z18.- should be used as an additional code.

In simple words: This code is used when someone has a bad reaction to something, but the exact cause or type of reaction isn't listed in other, more specific medical codes.It covers a wide range of negative effects from different things.

This ICD-10-CM code classifies adverse effects that do not fit into other, more specific categories within the injury, poisoning, and other external cause chapters.It encompasses a wide range of negative reactions resulting from exposure to various agents or events, excluding those explicitly categorized elsewhere.Appropriate use requires careful consideration of the specific adverse effect and its underlying cause to ensure accurate coding.

Example 1: A patient develops an unexplained rash after receiving a new medication.Since the specific type of drug reaction isn't clear, T78 is used.Further investigation might later lead to a more specific code., A patient experiences dizziness and nausea after exposure to a particular chemical in the workplace.Without clear identification of the specific toxin or reaction mechanism, T78 is applied until more information becomes available., A patient develops an adverse reaction to a contrast dye during a medical procedure.If the reaction is nonspecific and doesn't fall into other defined categories of contrast medium reaction, T78 may be appropriate, alongside codes specifying the procedure and contrast agent.

Detailed documentation is crucial for accurate coding.This includes a comprehensive description of the adverse effect (symptoms, onset, duration, severity), the suspected exposure (substance, event, timing), and any relevant medical history or allergies.If possible, lab results or diagnostic imaging findings should also be included to support the coding decision.The documentation should clearly explain why a more specific code isn't applicable.

** T78 is a "catch-all" code that should be avoided whenever possible.Thorough clinical documentation and consideration of more specific codes are essential to ensure accurate billing and reimbursement.Regular updates to the ICD-10-CM coding manual are necessary to account for changes and ensure the correct code is used.

  • Payment Status: Active
  • Specialties:Multiple specialties may use this code, depending on the nature of the adverse effect and the patient's condition.This could include internal medicine, allergy/immunology, toxicology, and others.
  • Place of Service:Office, Hospital (Inpatient/Outpatient), Emergency Room, Urgent Care, other
** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

Discover what matters.

iFrame™ AI's knowledge is aligned with and limited to the materials uploaded by users and should not be interpreted as medical, legal, or any other form of advice by iFrame™.