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 14 of 27 (2,651 total)
  • T49.2X5DBillable

    Adverse effect of local astringents and local detergents, subsequent encounter

  • T49.2X5SBillable

    Adverse effect of local astringents and local detergents, sequela

  • T49.2X6ABillable

    Underdosing of local astringents and local detergents, initial encounter

  • T49.2X6DBillable

    Underdosing of local astringents and local detergents, subsequent encounter

  • T49.2X6SBillable

    Underdosing of local astringents and local detergents, sequela

  • T49.3X5ABillable

    Adverse effect of emollients, demulcents and protectants, initial encounter

  • T49.3X5DBillable

    Adverse effect of emollients, demulcents and protectants, subsequent encounter

  • T49.3X5SBillable

    Adverse effect of emollients, demulcents and protectants, sequela

  • T49.3X6ABillable

    Underdosing of emollients, demulcents and protectants, initial encounter

  • T49.3X6DBillable

    Underdosing of emollients, demulcents and protectants, subsequent encounter

  • T49.3X6SBillable

    Underdosing of emollients, demulcents and protectants, sequela

  • T49.4X5ABillable

    Adverse effect of keratolytics, keratoplastics, and other hair treatment drugs and preparations, initial encounter

  • T49.4X5DBillable

    Adverse effect of keratolytics, keratoplastics, and other hair treatment drugs and preparations, subsequent encounter

  • T49.4X5SBillable

    Adverse effect of keratolytics, keratoplastics, and other hair treatment drugs and preparations, sequela

  • T49.4X6ABillable

    Underdosing of keratolytics, keratoplastics, and other hair treatment drugs and preparations, initial encounter

  • T49.4X6DBillable

    Underdosing of keratolytics, keratoplastics, and other hair treatment drugs and preparations, subsequent encounter

  • T49.4X6SBillable

    Underdosing of keratolytics, keratoplastics, and other hair treatment drugs and preparations, sequela

  • T49.5X5ABillable

    Adverse effect of ophthalmological drugs and preparations, initial encounter

  • T49.5X5DBillable

    Adverse effect of ophthalmological drugs and preparations, subsequent encounter

  • T49.5X5SBillable

    Adverse effect of ophthalmological drugs and preparations, sequela

  • T49.5X6ABillable

    Underdosing of ophthalmological drugs and preparations, initial encounter

  • T49.5X6DBillable

    Underdosing of ophthalmological drugs and preparations, subsequent encounter

  • T49.5X6SBillable

    Underdosing of ophthalmological drugs and preparations, sequela

  • T49.6X5ABillable

    Adverse effect of otorhinolaryngological drugs and preparations, initial encounter

  • T49.6X5DBillable

    Adverse effect of otorhinolaryngological drugs and preparations, subsequent encounter

  • T49.6X5SBillable

    Adverse effect of otorhinolaryngological drugs and preparations, sequela

  • T49.6X6ABillable

    Underdosing of otorhinolaryngological drugs and preparations, initial encounter

  • T49.6X6DBillable

    Underdosing of otorhinolaryngological drugs and preparations, subsequent encounter

  • T49.6X6SBillable

    Underdosing of otorhinolaryngological drugs and preparations, sequela

  • T49.7X5ABillable

    Adverse effect of dental drugs, topically applied, initial encounter

  • T49.7X5DBillable

    Adverse effect of dental drugs, topically applied, subsequent encounter

  • T49.7X5SBillable

    Adverse effect of dental drugs, topically applied, sequela

  • T49.7X6ABillable

    Underdosing of dental drugs, topically applied, initial encounter

  • T49.7X6DBillable

    Underdosing of dental drugs, topically applied, subsequent encounter

  • T49.7X6SBillable

    Underdosing of dental drugs, topically applied, sequela

  • T49.8X5ABillable

    Adverse effect of other topical agents, initial encounter

  • T49.8X5DBillable

    Adverse effect of other topical agents, subsequent encounter

  • T49.8X5SBillable

    Adverse effect of other topical agents, sequela

  • T49.8X6ABillable

    Underdosing of other topical agents, initial encounter

  • T49.8X6DBillable

    Underdosing of other topical agents, subsequent encounter

  • T49.8X6SBillable

    Underdosing of other topical agents, sequela

  • T49.95XABillable

    Adverse effect of unspecified topical agent, initial encounter

  • T49.95XDBillable

    Adverse effect of unspecified topical agent, subsequent encounter

  • T49.95XSBillable

    Adverse effect of unspecified topical agent, sequela

  • T49.96XABillable

    Underdosing of unspecified topical agent, initial encounter

  • T49.96XDBillable

    Underdosing of unspecified topical agent, subsequent encounter

  • T49.96XSBillable

    Underdosing of unspecified topical agent, sequela

  • T50.0X5ABillable

    Adverse effect of mineralocorticoids and their antagonists, initial encounter

  • T50.0X5DBillable

    Adverse effect of mineralocorticoids and their antagonists, subsequent encounter

  • T50.0X5SBillable

    Adverse effect of mineralocorticoids and their antagonists, sequela

  • T50.0X6ABillable

    Underdosing of mineralocorticoids and their antagonists, initial encounter

  • T50.0X6DBillable

    Underdosing of mineralocorticoids and their antagonists, subsequent encounter

  • T50.0X6SBillable

    Underdosing of mineralocorticoids and their antagonists, sequela

  • T50.1X5ABillable

    Adverse effect of loop [high-ceiling] diuretics, initial encounter

  • T50.1X5DBillable

    Adverse effect of loop [high-ceiling] diuretics, subsequent encounter

  • T50.1X5SBillable

    Adverse effect of loop [high-ceiling] diuretics, sequela

  • T50.1X6ABillable

    Underdosing of loop [high-ceiling] diuretics, initial encounter

  • T50.1X6DBillable

    Underdosing of loop [high-ceiling] diuretics, subsequent encounter

  • T50.1X6SBillable

    Underdosing of loop [high-ceiling] diuretics, sequela

  • T50.2X5ABillable

    Adverse effect of carbonic-anhydrase inhibitors, benzothiadiazides and other diuretics, initial encounter

  • T50.2X5DBillable

    Adverse effect of carbonic-anhydrase inhibitors, benzothiadiazides and other diuretics, subsequent encounter

  • T50.2X5SBillable

    Adverse effect of carbonic-anhydrase inhibitors, benzothiadiazides and other diuretics, sequela

  • T50.2X6ABillable

    Underdosing of carbonic-anhydrase inhibitors, benzothiadiazides and other diuretics, initial encounter

  • T50.2X6DBillable

    Underdosing of carbonic-anhydrase inhibitors, benzothiadiazides and other diuretics, subsequent encounter

  • T50.2X6SBillable

    Underdosing of carbonic-anhydrase inhibitors, benzothiadiazides and other diuretics, sequela

  • T50.3X5ABillable

    Adverse effect of electrolytic, caloric and water-balance agents, initial encounter

  • T50.3X5DBillable

    Adverse effect of electrolytic, caloric and water-balance agents, subsequent encounter

  • T50.3X5SBillable

    Adverse effect of electrolytic, caloric and water-balance agents, sequela

  • T50.3X6ABillable

    Underdosing of electrolytic, caloric and water-balance agents, initial encounter

  • T50.3X6DBillable

    Underdosing of electrolytic, caloric and water-balance agents, subsequent encounter

  • T50.3X6SBillable

    Underdosing of electrolytic, caloric and water-balance agents, sequela

  • T50.4X5ABillable

    Adverse effect of drugs affecting uric acid metabolism, initial encounter

  • T50.4X5DBillable

    Adverse effect of drugs affecting uric acid metabolism, subsequent encounter

  • T50.4X5SBillable

    Adverse effect of drugs affecting uric acid metabolism, sequela

  • T50.4X6ABillable

    Underdosing of drugs affecting uric acid metabolism, initial encounter

  • T50.4X6DBillable

    Underdosing of drugs affecting uric acid metabolism, subsequent encounter

  • T50.4X6SBillable

    Underdosing of drugs affecting uric acid metabolism, sequela

  • T50.5X5ABillable

    Adverse effect of appetite depressants, initial encounter

  • T50.5X5DBillable

    Adverse effect of appetite depressants, subsequent encounter

  • T50.5X5SBillable

    Adverse effect of appetite depressants, sequela

  • T50.5X6ABillable

    Underdosing of appetite depressants, initial encounter

  • T50.5X6DBillable

    Underdosing of appetite depressants, subsequent encounter

  • T50.5X6SBillable

    Underdosing of appetite depressants, sequela

  • T50.6X5ABillable

    Adverse effect of antidotes and chelating agents, initial encounter

  • T50.6X5DBillable

    Adverse effect of antidotes and chelating agents, subsequent encounter

  • T50.6X5SBillable

    Adverse effect of antidotes and chelating agents, sequela

  • T50.6X6ABillable

    Underdosing of antidotes and chelating agents, initial encounter

  • T50.6X6DBillable

    Underdosing of antidotes and chelating agents, subsequent encounter

  • T50.6X6SBillable

    Underdosing of antidotes and chelating agents, sequela

  • T50.7X5ABillable

    Adverse effect of analeptics and opioid receptor antagonists, initial encounter

  • T50.7X5DBillable

    Adverse effect of analeptics and opioid receptor antagonists, subsequent encounter

  • T50.7X5SBillable

    Adverse effect of analeptics and opioid receptor antagonists, sequela

  • T50.7X6ABillable

    Underdosing of analeptics and opioid receptor antagonists, initial encounter

  • T50.7X6DBillable

    Underdosing of analeptics and opioid receptor antagonists, subsequent encounter

  • T50.7X6SBillable

    Underdosing of analeptics and opioid receptor antagonists, sequela

  • T50.8X5ABillable

    Adverse effect of diagnostic agents, initial encounter

  • T50.8X5DBillable

    Adverse effect of diagnostic agents, subsequent encounter

  • T50.8X5SBillable

    Adverse effect of diagnostic agents, sequela

  • T50.8X6ABillable

    Underdosing of diagnostic agents, initial encounter

  • T50.8X6DBillable

    Underdosing of diagnostic agents, subsequent encounter