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2025 ICD-10-CM code T88.6XXA

Anaphylactic reaction due to adverse effect of correct drug or medicament properly administered, initial encounter.

Do not use this code for serum or food related anaphylaxis. Use an additional code to specify the drug causing the anaphylactic reaction (T36-T50 with fifth/sixth character 5). Excludes1: anaphylactic reaction due to serum (T80.5-) anaphylactic shock or reaction due to adverse food reaction (T78.0-)

The 7th character of the code is used to indicate the encounter type (A=initial encounter, D=subsequent encounter).

Medical necessity is established by the presence of a life-threatening anaphylactic reaction as a direct result of receiving a correctly prescribed and properly administered drug.The documentation must clearly support the diagnosis of anaphylaxis, rather than a milder allergic reaction.

The clinician is responsible for documenting the details of the anaphylactic reaction, confirming the correct prescription and proper administration of the drug, distinguishing it from other allergic reactions, and providing appropriate emergency care and follow-up.

IMPORTANT:Use additional code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

In simple words: This code is used when someone has a severe, whole-body allergic reaction (anaphylaxis) to a medicine that was prescribed and given correctly the first time they are seen for it.

This code describes an initial encounter for an anaphylactic reaction resulting from the adverse effect of a correctly prescribed and administered drug or medication.It is important to note this code is specifically for when the medication was both correctly prescribed and properly administered, and the reaction is a true anaphylaxis.

Example 1: A patient experiences a sudden onset of hives, difficulty breathing, and dizziness after receiving their first dose of a correctly prescribed antibiotic in a clinic. This is determined to be anaphylaxis., A patient develops swelling of the face, throat tightness, and a drop in blood pressure following a properly administered injection of a prescribed medication during an outpatient surgical procedure. This is documented as an anaphylactic reaction., A patient experiences an anaphylactic reaction to a drug administered during inpatient care.The physician documents this was the correct medication and administered properly.

Detailed documentation should include signs and symptoms of anaphylaxis (e.g., hives, angioedema, respiratory distress, hypotension), the time of onset relative to drug administration, the name and dosage of the drug administered, confirmation of the correct prescription and proper administration technique, and the treatment provided.

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