T49.1X6A
Underdosing of antipruritics, initial encounter
T49.1X6A (also written T491X6A) is a billable ICD-10-CM diagnosis code for underdosing of antipruritics, initial encounter. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 180 codes in category T49 (Poisoning by, adverse effect of and underdosing of topical agents primarily affecting skin and mucous membrane and by ophthalmological, otorhinorlaryngological and dental drugs). Its 7th character, A, means initial encounter. Its coding notes include a Code first instruction, a Use additional code instruction, 1 Excludes1 entry and 7 Excludes2 entries.
7th character
Category T49 requires a 7th character.
Guidelines tips
From the FY2027 Official Guidelines. ICD10Ref adds no rules of its own.
The 7th character depends on whether the patient is in active treatment, not on who sees the patient. An aftercare Z code is not used for injury aftercare.
T36-T65 codes already include the substance and the intent, so no additional external cause code is required. Do not code directly from the Table of Drugs and Chemicals.
Code first
If the underlying condition listed here is present and known, sequence it first.
Also from chapter/block level (7 notes)
Use additional code
Add the listed code as a secondary code, if known.
Also from chapter/block level (5 notes)
- code to identify any retained foreign body, if applicable (Z18.-)
Excludes1
Not coded here. The listed conditions generally should not be reported together.
Excludes2
Not included here. Both codes may be reported if the patient has both conditions.
Also from chapter/block level (7 notes)
- birth trauma (P10-P15)
- obstetric trauma (O70-O71)
Care settings
How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.
Hospice: not accepted as primary
Not accepted as the principal diagnosis on a hospice claim (bill types 081x and 082x). The Integrated OCE returns an edit for this code.
Reason: Supplementary or additional code, not allowed as principal diagnosis.
Includes
Further defines or gives examples of the content of the category.
- poisoning by, adverse effect of and underdosing of glucocorticoids, topically used
Also from chapter/block level (4 notes)
- adverse effect of correct substance properly administered
- poisoning by overdose of substance
- poisoning by wrong substance given or taken in error
- underdosing by (inadvertently) (deliberately) taking less substance than prescribed or instructed
Notes
Also from chapter/block level (3 notes)
- The drug giving rise to the adverse effect should be identified by use of codes from categories T36-T50 with fifth or sixth character 5.
- Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
- The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.