T45.0X5A: Adverse effect of antiallergic and antiemetic drugs, initial encounter

T45.0X5A, adverse effect of antiallergic and antiemetic drugs, initial encounter, is listed as a covered diagnosis in 4 Medicare billing and coding articles that apply to 35 HCPCS Level II codes, including J9267 (Injection, paclitaxel, 1 mg), J9264 (Injection, paclitaxel protein-bound particles, 1 mg), J2785 (Injection, regadenoson, 0.1 mg). The articles come from 4 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.

HCPCS Level II codes with T45.0X5A as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
J9267Injection, paclitaxel, 1 mgSpecial coverage instructions apply—1
J9264Injection, paclitaxel protein-bound particles, 1 mgCarrier judgment—1
J2785Injection, regadenoson, 0.1 mgCarrier judgment—1
J0461Injection, atropine sulfate, 0.01 mgSpecial coverage instructions apply—1
J3490Unclassified drugsSpecial coverage instructions apply—1
J0153Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)Special coverage instructions apply—1
Q9957Injection, perflutren lipid microspheres, per mlCarrier judgment—1
J1250Injection, dobutamine hydrochloride, per 250 mgSpecial coverage instructions apply—1
J0280Injection, aminophyllin, up to 250 mgSpecial coverage instructions apply—1
J1245Injection, dipyridamole, per 10 mgSpecial coverage instructions apply—1
Q9956Injection, octafluoropropane microspheres, per mlCarrier judgment—1
C9399Unclassified drugs or biologicalsSpecial coverage instructions apply—1
A9700Supply of injectable contrast material for use in echocardiography, per studySpecial coverage instructions apply—1
C8921Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; completeSpecial coverage instructions apply—1
C8922Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; follow-up or limited studySpecial coverage instructions apply—1
C8923Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiographySpecial coverage instructions apply—1
C8924Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited studySpecial coverage instructions apply—1
C8928Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and reportSpecial coverage instructions apply—1
C8929Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiographySpecial coverage instructions apply—1
C8930Transthoracic echocardiography, with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with physician supervisionSpecial coverage instructions apply—1
Q9955Injection, perflexane lipid microspheres, per mlCarrier judgment—1
G0480Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performedCarrier judgment—1
G0483Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performedCarrier judgment—1
G0482Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performedCarrier judgment—1
G0481Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performedCarrier judgment—1

10 more codes are listed. See every code with payment by region in Caduvo.

Medicare policy articles listing T45.0X5A

A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.

Other T45 diagnoses (Poisoning by, adverse effect of and underdosing of primarily systemic and hematological agents, not elsewhere classified)

Frequently asked questions

Does Medicare cover T45.0X5A (Adverse effect of antiallergic and antiemetic drugs…)?

Medicare covers items and services, not diagnoses. 4 Medicare billing and coding articles list T45.0X5A as a covered diagnosis for 35 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.

Which HCPCS codes can be billed with ICD-10 T45.0X5A?

The Level II codes from the policies most specific to this diagnosis are J9267 (Injection, paclitaxel, 1 mg, 1 article); J9264 (Injection, paclitaxel protein-bound particles, 1 mg, 1 article); J2785 (Injection, regadenoson, 0.1 mg, 1 article); J0461 (Injection, atropine sulfate, 0.01 mg, 1 article); J3490 (Unclassified drugs, 1 article). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list T45.0X5A?

A52450 (Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)); A57306 (Billing and Coding: Transthoracic Echocardiography (TTE)); A56645 (Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing), and 1 more article.

What is ICD-10-CM code T45.0X5A?

T45.0X5A is the ICD-10-CM code for adverse effect of antiallergic and antiemetic drugs, initial encounter, in category T45 (Poisoning by, adverse effect of and underdosing of primarily systemic and hematological agents, not elsewhere classified), chapter 19: Injury, poisoning and other consequences of external causes.

Next steps

Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.

Chapter 19: Injury, poisoning and other consequences of external causes · All diagnoses · HCPCS lookup