T45.1X5A: Adverse effect of antineoplastic and immunosuppressive drugs, initial encounter

T45.1X5A, adverse effect of antineoplastic and immunosuppressive drugs, initial encounter, is listed as a covered diagnosis in 7 Medicare billing and coding articles that apply to 38 HCPCS Level II codes, including J0461 (Injection, atropine sulfate, 0.01 mg), J0153 (Injection, adenosine, 1 mg (not to be used to report any…), J1250 (Injection, dobutamine hydrochloride, per 250 mg). The articles come from 3 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 T45.1X5A as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
J0461Injection, atropine sulfate, 0.01 mgSpecial coverage instructions apply—5
J0153Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)Special coverage instructions apply—5
J1250Injection, dobutamine hydrochloride, per 250 mgSpecial coverage instructions apply—5
J0280Injection, aminophyllin, up to 250 mgSpecial coverage instructions apply—5
J1245Injection, dipyridamole, per 10 mgSpecial coverage instructions apply—5
A9700Supply of injectable contrast material for use in echocardiography, per studySpecial coverage instructions apply—3
J2785Injection, regadenoson, 0.1 mgCarrier judgment—2
Q9957Injection, perflutren lipid microspheres, per mlCarrier judgment—2
Q9956Injection, octafluoropropane microspheres, per mlCarrier judgment—2
C8921Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; completeSpecial coverage instructions apply—2
C8922Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; follow-up or limited studySpecial coverage instructions apply—2
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—2
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—2
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—2
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—2
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—2
Q9955Injection, perflexane lipid microspheres, per mlCarrier judgment—2
A9500Technetium tc-99m sestamibi, diagnostic, per study doseCarrier judgment—1
A9502Technetium tc-99m tetrofosmin, diagnostic, per study doseCarrier judgment—1
A9555Rubidium rb-82, diagnostic, per study dose, up to 60 millicuriesCarrier judgment—1
A9505Thallium tl-201 thallous chloride, diagnostic, per millicurieCarrier judgment—1
A9526Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuriesCarrier judgment—1
A4641Radiopharmaceutical, diagnostic, not otherwise classifiedCarrier judgment—1
A9501Technetium tc-99m teboroxime, diagnostic, per study doseCarrier judgment—1
A9611Flurpiridaz f 18, diagnostic, 1 millicurieCarrier judgment—1

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

Medicare policy articles listing T45.1X5A

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 T45.1X5A (Adverse effect of antineoplastic and immunosuppressive…)?

Medicare covers items and services, not diagnoses. 7 Medicare billing and coding articles list T45.1X5A as a covered diagnosis for 38 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 T45.1X5A?

The Level II codes from the policies most specific to this diagnosis are J0461 (Injection, atropine sulfate, 0.01 mg, 5 articles); J0153 (Injection, adenosine, 1 mg (not to be used to report any…, 5 articles); J1250 (Injection, dobutamine hydrochloride, per 250 mg, 5 articles); J0280 (Injection, aminophyllin, up to 250 mg, 5 articles); J1245 (Injection, dipyridamole, per 10 mg, 5 articles). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list T45.1X5A?

A56476 (Billing and Coding: Cardiac Radionuclide Imaging); A52450 (Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)); A57306 (Billing and Coding: Transthoracic Echocardiography (TTE)), and 4 more articles.

What is ICD-10-CM code T45.1X5A?

T45.1X5A is the ICD-10-CM code for adverse effect of antineoplastic and immunosuppressive 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