2024 ICD-10-CM Diagnosis Code T42.4X3S

Poisoning by benzodiazepines, assault, sequela

ICD-10-CM Code:
T42.4X3S
ICD-10 Code for:
Poisoning by benzodiazepines, 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 antiepileptic, sedative- hypnotic and antiparkinsonism drugs
        (T42)

T42.4X3S is a billable diagnosis code used to specify a medical diagnosis of poisoning by benzodiazepines, 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.

T42.4X3S 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 benzodiazepines 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 Information

  • Alprazolam

    a triazolobenzodiazepine compound with antianxiety and sedative-hypnotic actions, that is efficacious in the treatment of panic disorders, with or without agoraphobia, and in generalized anxiety disorders. (from ama drug evaluations annual, 1994, p238)
  • Bromazepam

    one of the benzodiazepines that is used in the treatment of anxiety disorders.
  • Chlordiazepoxide

    an anxiolytic benzodiazepine derivative with anticonvulsant, sedative, and amnesic properties. it has also been used in the symptomatic treatment of alcohol withdrawal.
  • Clobazam

    a benzodiazepine derivative that is a long-acting gaba-a receptor agonist. it is used as an antiepileptic in the treatment of seizures, including seizures associated with lennox-gastaut syndrome. it is also used as an anxiolytic, for the short-term treatment of acute anxiety.
  • Clonazepam

    an anticonvulsant used for several types of seizures, including myotonic or atonic seizures, photosensitive epilepsy, and absence seizures, although tolerance may develop. it is seldom effective in generalized tonic-clonic or partial seizures. the mechanism of action appears to involve the enhancement of gamma-aminobutyric acid receptor responses.
  • Clozapine

    a tricylic dibenzodiazepine, classified as an atypical antipsychotic agent. it binds several types of central nervous system receptors, and displays a unique pharmacological profile. clozapine is a serotonin antagonist, with strong binding to 5-ht 2a/2c receptor subtype. it also displays strong affinity to several dopaminergic receptors, but shows only weak antagonism at the dopamine d2 receptor, a receptor commonly thought to modulate neuroleptic activity. agranulocytosis is a major adverse effect associated with administration of this agent.
  • Diazepam

    a benzodiazepine with anticonvulsant, anxiolytic, sedative, muscle relaxant, and amnesic properties and a long duration of action. its actions are mediated by enhancement of gamma-aminobutyric acid activity.
  • Diazepam Binding Inhibitor

    an 86-amino acid polypeptide, found in central and peripheral tissues, that displaces diazepam from the benzodiazepine recognition site on the gamma-aminobutyric acid receptor (receptors, gaba). it also binds medium- and long-chain acyl-coa esters and serves as an acyl-coa transporter. this peptide regulates lipid metabolism.
  • Receptors, GABA-A

    cell surface proteins which bind gamma-aminobutyric acid and contain an integral membrane chloride channel. each receptor is assembled as a pentamer from a pool of at least 19 different possible subunits. the receptors belong to a superfamily that share a common cysteine loop.
  • Estazolam

    a benzodiazepine with anticonvulsant, hypnotic, and muscle relaxant properties. it has been shown in some cases to be more potent than diazepam or nitrazepam.
  • Flunitrazepam

    a benzodiazepine with pharmacologic actions similar to those of diazepam that can cause anterograde amnesia. some reports indicate that it is used as a date rape drug and suggest that it may precipitate violent behavior. the united states government has banned the importation of this drug.
  • Flurazepam

    a benzodiazepine derivative used mainly as a hypnotic.
  • Lorazepam

    a benzodiazepine used as an anti-anxiety agent with few side effects. it also has hypnotic, anticonvulsant, and considerable sedative properties and has been proposed as a preanesthetic agent.
  • Medazepam

    a benzodiazepine derivative used in the treatment of anxiety. it has sedative, muscle relaxant, and anticonvulsant properties. one of its metabolites is diazepam and one of its excretion products is oxazepam.
  • Midazolam

    a short-acting hypnotic-sedative drug with anxiolytic and amnestic properties. it is used in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. the short duration and cardiorespiratory stability makes it useful in poor-risk, elderly, and cardiac patients. it is water-soluble at ph less than 4 and lipid-soluble at physiological ph.
  • Nitrazepam

    a benzodiazepine derivative used as an anticonvulsant and hypnotic.
  • Nordazepam

    an intermediate in the metabolism of diazepam to oxazepam. it may have actions similar to those of diazepam.
  • Oxazepam

    a benzodiazepine used in the treatment of anxiety, alcohol withdrawal, and insomnia.
  • Prazepam

    a benzodiazepine that is used in the treatment of anxiety disorders.
  • Temazepam

    a benzodiazepine that acts as a gamma-aminobutyric acid modulator and anti-anxiety agent.
  • Triazolam

    a short-acting benzodiazepine used in the treatment of insomnia. some countries temporarily withdrew triazolam from the market because of concerns about adverse reactions, mostly psychological, associated with higher dose ranges. its use at lower doses with appropriate care and labeling has been reaffirmed by the fda and most other countries.

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 antiepileptic, sedative- hypnotic and antiparkinsonism drugs (T42). Use the following options for the aplicable episode of care:

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

Present on Admission (POA)

T42.4X3S 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 T42.4X3S 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 T42.4X3 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
AlprazolamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
BentazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
BenzodiapinT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
Benzodiazepine NECT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
BromazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
BrotizolamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
CamazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
CarpipramineT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
ChlordiazepoxideT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
ClobazamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
ClonazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
Clorazepate (dipotassium)T42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
ClotiazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
CloxazolamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
ClozapineT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
DalmaneT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
DelorazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
DiazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
EstazolamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
EtizolamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
FludiazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
FlunitrazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
FlurazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
FlutazolamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
FlutoprazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
HalazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
HaloxazolamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
KetazolamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
LibriumT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
LoprazolamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
LorazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
LormetazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
MedazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
MexazolamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
MidazolamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
NimetazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
NitrazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
NordazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
OxazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
OxazolamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
PerlapineT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
PinazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
PrazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
QuazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
RohypnolT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
SeraxT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
TemazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
TetrazepamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
TofisopamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
TranxeneT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
TriazolamT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6
ValiumT42.4X1T42.4X2T42.4X3T42.4X4T42.4X5T42.4X6

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.