2024 ICD-10-CM Diagnosis Code T40.2X3S

Poisoning by other opioids, assault, sequela

ICD-10-CM Code:
T40.2X3S
ICD-10 Code for:
Poisoning by other opioids, assault, sequela
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Not chronic
Code Navigator:

Code Classification

  • Injury, poisoning and certain other consequences of external causes
    (S00–T88)
    • Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances
      (T36-T50)
      • Poisoning by, adverse effect of and underdosing of narcotics and psychodysleptics [hallucinogens]
        (T40)

T40.2X3S is a billable diagnosis code used to specify a medical diagnosis of poisoning by other opioids, assault, sequela. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

T40.2X3S is a sequela code, includes a 7th character and should be used for complications that arise as a direct result of a condition like poisoning by other opioids assault. According to ICD-10-CM Guidelines a "sequela" code should be used for chronic or residual conditions that are complications of an initial acute disease, illness or injury. The most common sequela is pain. Usually, two diagnosis codes are needed when reporting sequela. The first code describes the nature of the sequela while the second code describes the sequela or late effect.

Clinical Classification

Clinical CategoryCCSR Category CodeInpatient Default CCSROutpatient Default CCSR
Mental and substance use disorders; sequelaMBD034Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Poisoning/toxic effect/adverse effects/underdosing, sequelaINJ075N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis.N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.

Clinical Information

  • Codeine

    an opioid analgesic related to morphine but with less potent analgesic properties and mild sedative effects. it also acts centrally to suppress cough.
  • Dextrorphan

    dextro form of levorphanol. it acts as a noncompetitive nmda receptor antagonist, among other effects, and has been proposed as a neuroprotective agent. it is also a metabolite of dextromethorphan.
  • Dihydromorphine

    a semisynthetic analgesic used in the study of narcotic receptors.
  • Ethylmorphine

    a narcotic analgesic and antitussive. it is metabolized in the liver by ethylmorphine-n-demethylase and used as an indicator of liver function.
  • Ethylmorphine-N-Demethylase

    a drug-metabolizing enzyme of the hepatic microsomal oxidase system which catalyzes the oxidation of the n-methyl group of ethylmorphine with the formation of formaldehyde.
  • Etorphine

    a narcotic analgesic morphinan used as a sedative in veterinary practice.
  • Hydrocodone

    narcotic analgesic related to codeine, but more potent and more addicting by weight. it is used also as cough suppressant.
  • Hydromorphone

    an opioid analgesic made from morphine and used mainly as an analgesic. it has a shorter duration of action than morphine.
  • Glucuronosyltransferase

    a family of enzymes accepting a wide range of substrates, including phenols, alcohols, amines, and fatty acids. they function as drug-metabolizing enzymes that catalyze the conjugation of udpglucuronic acid to a variety of endogenous and exogenous compounds. ec 2.4.1.17.
  • Morphine

    the principal alkaloid in opium and the prototype opiate analgesic and narcotic. morphine has widespread effects in the central nervous system and on smooth muscle.
  • Morphine Dependence

    strong dependence, both physiological and emotional, upon morphine.
  • Morphine Derivatives

    analogs or derivatives of morphine.
  • Receptors, Opioid, mu

    a class of opioid receptors recognized by its pharmacological profile. mu opioid receptors bind, in decreasing order of affinity, endorphins, dynorphins, met-enkephalin, and leu-enkephalin. they have also been shown to be molecular receptors for morphine.
  • Oxycodone

    a semisynthetic derivative of codeine.
  • Oxymorphone

    an opioid analgesic with actions and uses similar to those of morphine, apart from an absence of cough suppressant activity. it is used in the treatment of moderate to severe pain, including pain in obstetrics. it may also be used as an adjunct to anesthesia. (from martindale, the extra pharmacopoeia, 30th ed, p1092)
  • Promedol

    a narcotic analgesic similar to meperidine; it exists in four stereoisomers, two of which, the beta (isopromedol) and the gamma (trimeperidine) are active.
  • Thebaine

    a drug that is derived from opium, which contains from 0.3-1.5% thebaine depending on its origin. it produces strychnine-like convulsions rather than narcosis. it may be habit-forming and is a controlled substance (opiate) listed in the u.s. code of federal regulations, title 21 part 1308.12 (1985). (from merck index, 11th ed)

Coding Guidelines

When coding a poisoning or reaction to the improper use of a medication (e.g., overdose, wrong substance given or taken in error, wrong route of administration), first assign the appropriate code from categories T36-T50. The poisoning codes have an associated intent as their 5th or 6th character (accidental, intentional self-harm, assault and undetermined. If the intent of the poisoning is unknown or unspecified, code the intent as accidental intent. The undetermined intent is only for use if the documentation in the record specifies that the intent cannot be determined. Use additional code(s) for all manifestations of poisonings.

The appropriate 7th character is to be added to each code from block Poisoning by, adverse effect of and underdosing of narcotics and psychodysleptics [hallucinogens] (T40). Use the following options for the aplicable episode of care:

  • A - initial encounter
  • D - subsequent encounter
  • S - sequela

Present on Admission (POA)

T40.2X3S is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.

CMS POA Indicator Options and Definitions

POA IndicatorReason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert T40.2X3S to ICD-9-CM

  • ICD-9-CM Code: 909.0 - Late eff drug poisoning
    Combination Flag - Multiple codes are needed to describe the source diagnosis code. Correct coding should be done based on contextual judgment.
  • ICD-9-CM Code: E969 - Late effect assault
    Combination Flag - Multiple codes are needed to describe the source diagnosis code. Correct coding should be done based on contextual judgment.

Table of Drugs and Chemicals

The parent code T40.2X3 of the current diagnosis code is referenced in the Table of Drugs and Chemicals, this table contains a classification of drugs, industrial solvents, corrosive gases, noxious plants, pesticides, and other toxic agents.

According to ICD-10-CM coding guidelines it is advised to do not code directly from the Table of Drugs and Chemicals, instead always refer back to the Tabular List when doing the initial coding. Each substance in the table is assigned a code according to the poisoning classification and external causes of adverse effects. It is important to use as many codes as necessary to specify all reported drugs, medicinal or chemical substances. If the same diagnosis code describes the causative agent for more than one adverse reaction, poisoning, toxic effect or underdosing, utilize the code only once.

Substance Poisoning
Accidental
(unintentional)
Poisoning
Accidental
(self-harm)
Poisoning
Assault
Poisoning
Undetermined
Adverse
effect
Underdosing
14-hydroxydihydro-morphinoneT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
AcemorphanT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
AcetorphineT40.2X1T40.2X2T40.2X3T40.2X4  
AcetyldihydrocodeineT40.2X1T40.2X2T40.2X3T40.2X4  
AcetyldihydrocodeinoneT40.2X1T40.2X2T40.2X3T40.2X4  
AlvodineT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
BenzomorphanT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
Blue velvetT40.2X1T40.2X2T40.2X3T40.2X4  
CliradonT40.2X1T40.2X2T40.2X3T40.2X4  
CodeineT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
DemerolT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
DesocodeineT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
DesomorphineT40.2X1T40.2X2T40.2X3T40.2X4  
DextrorphanT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
DifencloxazineT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
DihydrocodeineT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
DihydrocodeinoneT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
DihydrohydroxycodeinoneT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
DihydrohydroxymorphinoneT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
DihydroisocodeineT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
DihydromorphineT40.2X1T40.2X2T40.2X3T40.2X4  
DihydromorphinoneT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
DihydroxycodeinoneT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
DilaudidT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
DioninT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
DrocodeT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
DromoranT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
EthylmorphineT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
EtorphineT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
EucodalT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
HeptalginT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
HycodanT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
HydrocodoneT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
HydromorphinolT40.2X1T40.2X2T40.2X3T40.2X4  
HydromorphinoneT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
HydromorphoneT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
HydroxydihydrocodeinoneT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
LeritineT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
Levo-dromoranT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
MethylmorphineT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
MetoponT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
MorfinT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
MorphineT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
Morphine
  »antagonist
T40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
MorpholinylethylmorphineT40.2X1T40.2X2T40.2X3T40.2X4  
NicomorphineT40.2X1T40.2X2T40.2X3T40.2X4  
NisentilT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
NormorphineT40.2X1T40.2X2T40.2X3T40.2X4  
NumorphanT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
Opioid NECT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
OxycodoneT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
OxymorphoneT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
PalfiumT40.2X1T40.2X2T40.2X3T40.2X4  
ParacodinT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
ParzoneT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
PercodanT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
PeronineT40.2X1T40.2X2T40.2X3T40.2X4  
PhenadoxoneT40.2X1T40.2X2T40.2X3T40.2X4  
PhenomorphanT40.2X1T40.2X2T40.2X3T40.2X4  
PiminodineT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
PipadoneT40.2X1T40.2X2T40.2X3T40.2X4  
PrinadolT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
PromedolT40.2X1T40.2X2T40.2X3T40.2X4  
RacemoramideT40.2X1T40.2X2T40.2X3T40.2X4  
RacemorphanT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6
ThebaineT40.2X1T40.2X2T40.2X3T40.2X4T40.2X5T40.2X6

Patient Education


Poisoning

A poison is any substance that is harmful to your body. You might swallow it, inhale it, inject it, or absorb it through your skin. Any substance can be poisonous if too much is taken. Poisons can include:

  • Prescription or over-the-counter medicines taken in doses that are too high
  • Overdoses of illegal drugs
  • Carbon monoxide from gas appliances
  • Household products, such as laundry powder or furniture polish
  • Pesticides
  • Indoor or outdoor plants
  • Metals such as lead and mercury

The effects of poisoning range from short-term illness to brain damage, coma, and death. To prevent poisoning it is important to use and store products exactly as their labels say. Keep dangerous products where children can't get to them. Treatment for poisoning depends on the type of poison. If you suspect someone has been poisoned, call your local poison control center at 1-800-222-1222 right away.


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Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.