Clinical Guidance Category

Unacceptable Principal Diagnosis Codes

ICD-10-CM codes identified as unacceptable when used as principal diagnosis by MCE edit logic.

Source: Definitions of Medicare Code Edits v43.1, edit 9.
Linked Diagnostic CodesPage 11 of 27 (2,651 total)
  • T44.8X5DBillable

    Adverse effect of centrally-acting and adrenergic-neuron-blocking agents, subsequent encounter

  • T44.8X5SBillable

    Adverse effect of centrally-acting and adrenergic-neuron-blocking agents, sequela

  • T44.8X6ABillable

    Underdosing of centrally-acting and adrenergic-neuron-blocking agents, initial encounter

  • T44.8X6DBillable

    Underdosing of centrally-acting and adrenergic-neuron-blocking agents, subsequent encounter

  • T44.8X6SBillable

    Underdosing of centrally-acting and adrenergic-neuron-blocking agents, sequela

  • T44.905ABillable

    Adverse effect of unspecified drugs primarily affecting the autonomic nervous system, initial encounter

  • T44.905DBillable

    Adverse effect of unspecified drugs primarily affecting the autonomic nervous system, subsequent encounter

  • T44.905SBillable

    Adverse effect of unspecified drugs primarily affecting the autonomic nervous system, sequela

  • T44.906ABillable

    Underdosing of unspecified drugs primarily affecting the autonomic nervous system, initial encounter

  • T44.906DBillable

    Underdosing of unspecified drugs primarily affecting the autonomic nervous system, subsequent encounter

  • T44.906SBillable

    Underdosing of unspecified drugs primarily affecting the autonomic nervous system, sequela

  • T44.995ABillable

    Adverse effect of other drug primarily affecting the autonomic nervous system, initial encounter

  • T44.995DBillable

    Adverse effect of other drug primarily affecting the autonomic nervous system, subsequent encounter

  • T44.995SBillable

    Adverse effect of other drug primarily affecting the autonomic nervous system, sequela

  • T44.996ABillable

    Underdosing of other drug primarily affecting the autonomic nervous system, initial encounter

  • T44.996DBillable

    Underdosing of other drug primarily affecting the autonomic nervous system, subsequent encounter

  • T44.996SBillable

    Underdosing of other drug primarily affecting the autonomic nervous system, sequela

  • T45.0X5ABillable

    Adverse effect of antiallergic and antiemetic drugs, initial encounter

  • T45.0X5DBillable

    Adverse effect of antiallergic and antiemetic drugs, subsequent encounter

  • T45.0X5SBillable

    Adverse effect of antiallergic and antiemetic drugs, sequela

  • T45.0X6ABillable

    Underdosing of antiallergic and antiemetic drugs, initial encounter

  • T45.0X6DBillable

    Underdosing of antiallergic and antiemetic drugs, subsequent encounter

  • T45.0X6SBillable

    Underdosing of antiallergic and antiemetic drugs, sequela

  • T45.1X5ABillable

    Adverse effect of antineoplastic and immunosuppressive drugs, initial encounter

  • T45.1X5DBillable

    Adverse effect of antineoplastic and immunosuppressive drugs, subsequent encounter

  • T45.1X5SBillable

    Adverse effect of antineoplastic and immunosuppressive drugs, sequela

  • T45.1X6ABillable

    Underdosing of antineoplastic and immunosuppressive drugs, initial encounter

  • T45.1X6DBillable

    Underdosing of antineoplastic and immunosuppressive drugs, subsequent encounter

  • T45.1X6SBillable

    Underdosing of antineoplastic and immunosuppressive drugs, sequela

  • T45.2X5ABillable

    Adverse effect of vitamins, initial encounter

  • T45.2X5DBillable

    Adverse effect of vitamins, subsequent encounter

  • T45.2X5SBillable

    Adverse effect of vitamins, sequela

  • T45.2X6ABillable

    Underdosing of vitamins, initial encounter

  • T45.2X6DBillable

    Underdosing of vitamins, subsequent encounter

  • T45.2X6SBillable

    Underdosing of vitamins, sequela

  • T45.3X5ABillable

    Adverse effect of enzymes, initial encounter

  • T45.3X5DBillable

    Adverse effect of enzymes, subsequent encounter

  • T45.3X5SBillable

    Adverse effect of enzymes, sequela

  • T45.3X6ABillable

    Underdosing of enzymes, initial encounter

  • T45.3X6DBillable

    Underdosing of enzymes, subsequent encounter

  • T45.3X6SBillable

    Underdosing of enzymes, sequela

  • T45.4X5ABillable

    Adverse effect of iron and its compounds, initial encounter

  • T45.4X5DBillable

    Adverse effect of iron and its compounds, subsequent encounter

  • T45.4X5SBillable

    Adverse effect of iron and its compounds, sequela

  • T45.4X6ABillable

    Underdosing of iron and its compounds, initial encounter

  • T45.4X6DBillable

    Underdosing of iron and its compounds, subsequent encounter

  • T45.4X6SBillable

    Underdosing of iron and its compounds, sequela

  • T45.515ABillable

    Adverse effect of anticoagulants, initial encounter

  • T45.515DBillable

    Adverse effect of anticoagulants, subsequent encounter

  • T45.515SBillable

    Adverse effect of anticoagulants, sequela

  • T45.516ABillable

    Underdosing of anticoagulants, initial encounter

  • T45.516DBillable

    Underdosing of anticoagulants, subsequent encounter

  • T45.516SBillable

    Underdosing of anticoagulants, sequela

  • T45.525ABillable

    Adverse effect of antithrombotic drugs, initial encounter

  • T45.525DBillable

    Adverse effect of antithrombotic drugs, subsequent encounter

  • T45.525SBillable

    Adverse effect of antithrombotic drugs, sequela

  • T45.526ABillable

    Underdosing of antithrombotic drugs, initial encounter

  • T45.526DBillable

    Underdosing of antithrombotic drugs, subsequent encounter

  • T45.526SBillable

    Underdosing of antithrombotic drugs, sequela

  • T45.605ABillable

    Adverse effect of unspecified fibrinolysis-affecting drugs, initial encounter

  • T45.605DBillable

    Adverse effect of unspecified fibrinolysis-affecting drugs, subsequent encounter

  • T45.605SBillable

    Adverse effect of unspecified fibrinolysis-affecting drugs, sequela

  • T45.606ABillable

    Underdosing of unspecified fibrinolysis-affecting drugs, initial encounter

  • T45.606DBillable

    Underdosing of unspecified fibrinolysis-affecting drugs, subsequent encounter

  • T45.606SBillable

    Underdosing of unspecified fibrinolysis-affecting drugs, sequela

  • T45.615ABillable

    Adverse effect of thrombolytic drugs, initial encounter

  • T45.615DBillable

    Adverse effect of thrombolytic drugs, subsequent encounter

  • T45.615SBillable

    Adverse effect of thrombolytic drugs, sequela

  • T45.616ABillable

    Underdosing of thrombolytic drugs, initial encounter

  • T45.616DBillable

    Underdosing of thrombolytic drugs, subsequent encounter

  • T45.616SBillable

    Underdosing of thrombolytic drugs, sequela

  • T45.625ABillable

    Adverse effect of hemostatic drug, initial encounter

  • T45.625DBillable

    Adverse effect of hemostatic drug, subsequent encounter

  • T45.625SBillable

    Adverse effect of hemostatic drug, sequela

  • T45.626ABillable

    Underdosing of hemostatic drugs, initial encounter

  • T45.626DBillable

    Underdosing of hemostatic drugs, subsequent encounter

  • T45.626SBillable

    Underdosing of hemostatic drugs, sequela

  • T45.695ABillable

    Adverse effect of other fibrinolysis-affecting drugs, initial encounter

  • T45.695DBillable

    Adverse effect of other fibrinolysis-affecting drugs, subsequent encounter

  • T45.695SBillable

    Adverse effect of other fibrinolysis-affecting drugs, sequela

  • T45.696ABillable

    Underdosing of other fibrinolysis-affecting drugs, initial encounter

  • T45.696DBillable

    Underdosing of other fibrinolysis-affecting drugs, subsequent encounter

  • T45.696SBillable

    Underdosing of other fibrinolysis-affecting drugs, sequela

  • T45.7X5ABillable

    Adverse effect of anticoagulant antagonists, vitamin K and other coagulants, initial encounter

  • T45.7X5DBillable

    Adverse effect of anticoagulant antagonists, vitamin K and other coagulants, subsequent encounter

  • T45.7X5SBillable

    Adverse effect of anticoagulant antagonists, vitamin K and other coagulants, sequela

  • T45.7X6ABillable

    Underdosing of anticoagulant antagonist, vitamin K and other coagulants, initial encounter

  • T45.7X6DBillable

    Underdosing of anticoagulant antagonist, vitamin K and other coagulants, subsequent encounter

  • T45.7X6SBillable

    Underdosing of anticoagulant antagonist, vitamin K and other coagulants, sequela

  • T45.8X5ABillable

    Adverse effect of other primarily systemic and hematological agents, initial encounter

  • T45.8X5DBillable

    Adverse effect of other primarily systemic and hematological agents, subsequent encounter

  • T45.8X5SBillable

    Adverse effect of other primarily systemic and hematological agents, sequela

  • T45.8X6ABillable

    Underdosing of other primarily systemic and hematological agents, initial encounter

  • T45.8X6DBillable

    Underdosing of other primarily systemic and hematological agents, subsequent encounter

  • T45.8X6SBillable

    Underdosing of other primarily systemic and hematological agents, sequela

  • T45.95XABillable

    Adverse effect of unspecified primarily systemic and hematological agent, initial encounter

  • T45.95XDBillable

    Adverse effect of unspecified primarily systemic and hematological agent, subsequent encounter

  • T45.95XSBillable

    Adverse effect of unspecified primarily systemic and hematological agent, sequela

  • T45.96XABillable

    Underdosing of unspecified primarily systemic and hematological agent, initial encounter

  • T45.96XDBillable

    Underdosing of unspecified primarily systemic and hematological agent, subsequent encounter