T36 ICD-10-CM Code: Poisoning by, adverse effect of and underdosing of systemic antibiotics
T36 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software
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FY 2026 Apr update / Injury, poisoning and certain other consequences of external causes (S00-T88) / Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50)
T36
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidancePoisoning by, adverse effect of and underdosing of systemic antibiotics
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for T36. Check the code and parent instructions in the Code Book.
Excludes 2
Official- birth trauma (P10-P15)Inherited from S00-T88, T36-T50
- obstetric trauma (O70-O71)Inherited from S00-T88, T36-T50
- abuse and dependence of psychoactive substances (F10-F19)Inherited from S00-T88, T36-T50
- abuse of non-dependence-producing substances (F55.-)Inherited from S00-T88, T36-T50
- immunodeficiency due to drugs (D84.821)Inherited from S00-T88, T36-T50
- drug reaction and poisoning affecting newborn (P00-P96)Inherited from S00-T88, T36-T50
- pathological drug intoxication (inebriation) (F10-F19)Inherited from S00-T88, T36-T50
Related Codes
Includes
Official- adverse effect of correct substance properly administeredInherited from T36-T50
- poisoning by overdose of substanceInherited from T36-T50
- poisoning by wrong substance given or taken in errorInherited from T36-T50
- underdosing by (inadvertently) (deliberately) taking less substance than prescribed or instructedInherited from T36-T50
Excludes 1
Official- antineoplastic antibiotics (T45.1-)
- locally applied antibiotic NEC (T49.0)
- topically used antibiotic for ear, nose and throat (T49.6)
- topically used antibiotic for eye (T49.5)
- toxic reaction to local anesthesia in pregnancy (O29.3-)Inherited from T36-T50
Code First
Official- , for adverse effects, the nature of the adverse effect, such as:Inherited from T36-T50
- adverse effect NOS (T88.7)Inherited from T36-T50
- aspirin gastritis (K29.-)Inherited from T36-T50
- blood disorders (D56-D76)Inherited from T36-T50
- contact dermatitis (L23-L25)Inherited from T36-T50
- dermatitis due to substances taken internally (L27.-)Inherited from T36-T50
- nephropathy (N14.0-N14.2)Inherited from T36-T50
Use Additional
Official- code to identify any retained foreign body, if applicable (Z18.-)Inherited from S00-T88, T36-T50
- code(s) to specify:Inherited from S00-T88, T36-T50
- manifestations of poisoningInherited from S00-T88, T36-T50
- underdosing or failure in dosage during medical and surgical care (Y63.6, Y63.8-Y63.9)Inherited from S00-T88, T36-T50
- underdosing of medication regimen (Z91.12-, Z91.13-)Inherited from S00-T88, T36-T50
Code Also
OfficialNo Code Also instructions are included in this display for T36. Check the code and parent instructions in the Code Book.
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
- Code
- T36
- Description
- Poisoning by, adverse effect of and underdosing of systemic antibiotics
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- No
- Payment year
- 2026
Coder workflow notes
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What This Code Means
T36 is the ICD-10-CM diagnosis code for poisoning by, adverse effect of and underdosing of systemic antibiotics. T36 sits in the ICD-10-CM chapter for injury, poisoning and certain other consequences of external causes (s00-t88), within the section covering poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (t36-t50).
Header codes like T36 cannot be reported on claims directly; they organize child codes that share clinical context. Coders should select the billable child code that matches the documented presentation and then verify its current source-backed HCC mapping. Do not infer a child code or risk adjustment value from the header alone.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for T36 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.