T38.5 – Poisoning by, adverse effect of and underdosing of other estrogens and progestogens

ICD-10-CM 2027 diagnosis code · Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances

Non-billable header

ICD-10-CM code T38.5

Code: T38.5 (claims format: T385)
Description: Poisoning by, adverse effect of and underdosing of other estrogens and progestogens
Short description: Estrogens and progestogens
Billable: No – use a more specific code below
Valid for: Dates of service October 1, 2026 – September 30, 2027 (FY2027)
Chapter: 19. Injury, poisoning and certain other consequences of external causes (S00-T88)
Block: T36-T50 Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances
Parent codes: T38

Billable codes under T38.5

T38.5 is a header code and cannot be used on claims. Choose the most specific code:

T38.5X – Poisoning by, adverse effect of and underdosing of other estrogens and progestogensHeader (more codes below)

7th character values

Codes in this category need a 7th character to describe the encounter or episode of care (use placeholder X for empty positions).

Character	Meaning
`A`	initial encounter
`D`	subsequent encounter
`S`	sequela

Notes for T38.5

Applicable to:

Poisoning by, adverse effect of and underdosing of estrogens and progestogens mixtures and substitutes

Notes inherited from parent codes

Instructional notes at a category or block level apply to every code below it.

T38 – Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified

Excludes1 (not coded here):

mineralocorticoids and their antagonists (T50.0-)
oxytocic hormones (T48.0-)
parathyroid hormones and derivatives (T50.9-)

7th character note:

The appropriate 7th character is to be added to each code from category T38

Block T36-T50

Includes:

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

Excludes1 (not coded here):

toxic reaction to local anesthesia in pregnancy (O29.3-)

Excludes2 (not included here):

abuse and dependence of psychoactive substances (F10-F19)
abuse of non-dependence-producing substances (F55.-)
immunodeficiency due to drugs (D84.821)
drug reaction and poisoning affecting newborn (P00-P96)
pathological drug intoxication (inebriation) (F10-F19)

Code first:

, for adverse effects, the nature of the adverse effect, such as:
adverse effect NOS (T88.7)
aspirin gastritis (K29.-)
blood disorders (D56-D76)
contact dermatitis (L23-L25)
dermatitis due to substances taken internally (L27.-)
nephropathy (N14.0-N14.2)

Use additional code:

code(s) to specify:
manifestations of poisoning
underdosing or failure in dosage during medical and surgical care (Y63.6, Y63.8-Y63.9)
underdosing of medication regimen (Z91.12-, Z91.13-)

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.

Related codes in T38

Frequently asked questions

What is ICD-10 code T38.5?

T38.5 is the ICD-10-CM code for poisoning by, adverse effect of and underdosing of other estrogens and progestogens, in the block T36-T50 (Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances).

Is T38.5 a billable code?

No. T38.5 is a header code with more specific child codes; report one of the billable codes listed above.

What category does T38.5 belong to?

It belongs to category T38 – Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified.

Source: CDC/NCHS ICD-10-CM FY2027 code files, tabular list and index. Reference only – code assignment must follow the official ICD-10-CM guidelines and documentation in the medical record.