ICD-10 T49.1X5
Non-Billable HeaderAdverse effect of antipruritics
About ICD-10-CM T49.1X5
ICD-10-CM code T49.1X5 represents Adverse effect of antipruritics. This is a non-billable header code in the Injury, Poisoning, and External Causes chapter (block T49). The 2026 edition of ICD-10-CM T49.1X5 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Coding Tips for T49.1X5
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
Injury codes require a 7th character: A (initial encounter, active treatment), D (subsequent, healing/recovery), S (sequela, late effect of original injury). Codes with fewer than 6 characters need the placeholder X to bring them to 6 characters before adding the 7th. Wrong or missing 7th character is the #1 cause of injury claim denials.
Medicare LCD Coverage for T49.1X5
Local Coverage Determinations (LCDs) from CMS MACs that list T49.1X5 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing T49.1X5.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but T49.1X5 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with T49.1X5
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To T49.1X5
Other codes in section T36-T50 (Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances).
ICD-10 T49.1X5, Billing FAQ
Is ICD-10 code T49.1X5 billable? +
No, T49.1X5 is a non-billable header code. Use a more specific child code from block T49 when submitting claims.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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