2024 ICD-10-CM Diagnosis Code T45.1X4A
Poisoning by antineoplastic and immunosuppressive drugs, undetermined, initial encounter
- ICD-10-CM Code:
- T45.1X4A
- ICD-10 Code for:
- Poisoning by antineopl and immunosup drugs, undet, init
- Is Billable?
- Yes - Valid for Submission
- Chronic Condition Indicator: [1]
- Not chronic
- Code Navigator:
T45.1X4A is a billable diagnosis code used to specify a medical diagnosis of poisoning by antineoplastic and immunosuppressive drugs, undetermined, initial encounter. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.
T45.1X4A is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like poisoning by antineoplastic and immunosuppressive drugs undetermined. According to ICD-10-CM Guidelines an "initial encounter" doesn't necessarily means "initial visit". The 7th character should be used when the patient is undergoing active treatment regardless if new or different providers saw the patient over the course of a treatment. The appropriate 7th character codes should also be used even if the patient delayed seeking treatment for a condition.
Clinical Classification
Clinical Category | CCSR Category Code | Inpatient Default CCSR | Outpatient Default CCSR |
---|---|---|---|
External cause codes: intent of injury, undetermined | EXT023 | N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis. | N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis. |
External cause codes: poisoning by drug | EXT014 | N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis. | N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis. |
Poisoning by drugs, initial encounter | INJ022 | Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis. | Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis. |
Clinical Information
Aclarubicin
an anthracycline produced by streptomyces galilaeus. it has potent antineoplastic activity.Altretamine
a hexamethyl-2,4,6-triamine derivative of 1,3,5-triazine.Aminoglutethimide
an aromatase inhibitor that is used in the treatment of advanced breast cancer.Amsacrine
an aminoacridine derivative that intercalates into dna and is used as an antineoplastic agent.Anthramycin
a broad-spectrum spectrum antineoplastic antibiotic isolated from streptomyces refuineus var. thermotolerans. it has low toxicity, some activity against trichomonas and endamoeba, and inhibits rna and dna synthesis. it binds irreversibly to dna.Asparaginase
a hydrolase enzyme that converts l-asparagine and water to l-aspartate and nh3. ec 3.5.1.1.Azacitidine
a pyrimidine analogue that inhibits dna methyltransferase, impairing dna methylation. it is also an antimetabolite of cytidine, incorporated primarily into rna. azacytidine has been used as an antineoplastic agent.Azaserine
antibiotic substance produced by various streptomyces species. it is an inhibitor of enzymatic activities that involve glutamine and is used as an antineoplastic and immunosuppressive agent.Azathioprine
an immunosuppressive agent used in combination with cyclophosphamide and hydroxychloroquine in the treatment of rheumatoid arthritis. according to the fourth annual report on carcinogens (ntp 85-002, 1985), this substance has been listed as a known carcinogen. (merck index, 11th ed)Bleomycin
a complex of related glycopeptide antibiotics from streptomyces verticillus consisting of bleomycin a2 and b2. it inhibits dna metabolism and is used as an antineoplastic, especially for solid tumors.Carboplatin
an organoplatinum compound that possesses antineoplastic activity.Carmustine
a cell-cycle phase nonspecific alkylating antineoplastic agent. it is used in the treatment of brain tumors and various other malignant neoplasms. (from martindale, the extra pharmacopoeia, 30th ed, p462) this substance may reasonably be anticipated to be a carcinogen according to the fourth annual report on carcinogens (ntp 85-002, 1985). (from merck index, 11th ed)Chlorambucil
a nitrogen mustard alkylating agent used as antineoplastic for chronic lymphocytic leukemia, hodgkin's disease, and others. although it is less toxic than most other nitrogen mustards, it has been listed as a known carcinogen in the fourth annual report on carcinogens (ntp 85-002, 1985). (merck index, 11th ed)Chromomycin A3
glycosidic antibiotic from streptomyces griseus used as a fluorescent stain of dna and as an antineoplastic agent.Cisplatin
an inorganic and water-soluble platinum complex. after undergoing hydrolysis, it reacts with dna to produce both intra and interstrand crosslinks. these crosslinks appear to impair replication and transcription of dna. the cytotoxicity of cisplatin correlates with cellular arrest in the g2 phase of the cell cycle.Cyclophosphamide
precursor of an alkylating nitrogen mustard antineoplastic and immunosuppressive agent that must be activated in the liver to form the active aldophosphamide. it has been used in the treatment of lymphoma and leukemia. its side effect, alopecia, has been used for defleecing sheep. cyclophosphamide may also cause sterility, birth defects, mutations, and cancer.Arabinofuranosylcytosine Triphosphate
a triphosphate nucleotide analog which is the biologically active form of cytarabine. it inhibits nuclear dna synthesis.Cytarabine
a pyrimidine nucleoside analog that is used mainly in the treatment of leukemia, especially acute non-lymphoblastic leukemia. cytarabine is an antimetabolite antineoplastic agent that inhibits the synthesis of dna. its actions are specific for the s phase of the cell cycle. it also has antiviral and immunosuppressant properties. (from martindale, the extra pharmacopoeia, 30th ed, p472)Dacarbazine
an antineoplastic agent. it has significant activity against melanomas. (from martindale, the extra pharmacopoeia, 31st ed, p564)Dactinomycin
a compound composed of a two cyclic peptides attached to a phenoxazine that is derived from streptomyces parvullus. it binds to dna and inhibits rna synthesis (transcription), with chain elongation more sensitive than initiation, termination, or release. as a result of impaired mrna production, protein synthesis also declines after dactinomycin therapy. (from ama drug evaluations annual, 1993, p2015)Carbonyl Reductase (NADPH)
nadph-dependent reductase that catalyzes the reduction of many carbonyl compounds including quinones; prostaglandins; and xenobiotics.Daunorubicin
a very toxic anthracycline aminoglycoside antineoplastic isolated from streptomyces peucetius and others, used in treatment of leukemia and other neoplasms.Demecolcine
an alkaloid isolated from colchicum autumnale l. and used as an antineoplastic.Doxorubicin
antineoplastic antibiotic obtained from streptomyces peucetius. it is a hydroxy derivative of daunorubicin.Epirubicin
an anthracycline which is the 4'-epi-isomer of doxorubicin. the compound exerts its antitumor effects by interference with the synthesis and function of dna.Estramustine
a nitrogen mustard linked to estradiol, usually as phosphate; used to treat prostatic neoplasms; also has radiation protective properties.Etoposide
a semisynthetic derivative of podophyllotoxin that exhibits antitumor activity. etoposide inhibits dna synthesis by forming a complex with topoisomerase ii and dna. this complex induces breaks in double stranded dna and prevents repair by topoisomerase ii binding. accumulated breaks in dna prevent entry into the mitotic phase of cell division, and lead to cell death. etoposide acts primarily in the g2 and s phases of the cell cycle.Floxuridine
an antineoplastic antimetabolite that is metabolized to fluorouracil when administered by rapid injection; when administered by slow, continuous, intra-arterial infusion, it is converted to floxuridine monophosphate. it has been used to treat hepatic metastases of gastrointestinal adenocarcinomas and for palliation in malignant neoplasms of the liver and gastrointestinal tract.Fluorouracil
a pyrimidine analog that is an antineoplastic antimetabolite. it interferes with dna synthesis by blocking the thymidylate synthetase conversion of deoxyuridylic acid to thymidylic acid.Goserelin
a synthetic long-acting agonist of gonadotropin-releasing hormone. goserelin is used in treatments of malignant neoplasms of the prostate, uterine fibromas, and metastatic breast cancer.Hydroxyurea
an antineoplastic agent that inhibits dna synthesis through the inhibition of ribonucleoside diphosphate reductase.Idarubicin
an orally administered anthracycline antineoplastic. the compound has shown activity against breast neoplasms; lymphoma; and leukemia.Ifosfamide
positional isomer of cyclophosphamide which is active as an alkylating agent and an immunosuppressive agent.Lomustine
an alkylating agent of value against both hematologic malignancies and solid tumors.Mannomustine
nitrogen mustard derivative alkylating agent used as antineoplastic. it causes severe bone marrow depression and is a powerful vesicant.Mechlorethamine
a biologic alkylating agent that exerts its cytotoxic effects by forming dna adducts and dna interstrand crosslinks, thereby inhibiting rapidly proliferating cells. the hydrochloride is an antineoplastic agent used to treat hodgkin disease and lymphoma.Melphalan
an alkylating nitrogen mustard that is used as an antineoplastic in the form of the levo isomer - melphalan, the racemic mixture - merphalan, and the dextro isomer - medphalan; toxic to bone marrow, but little vesicant action; potential carcinogen.Mercaptopurine
an antimetabolite antineoplastic agent with immunosuppressant properties. it interferes with nucleic acid synthesis by inhibiting purine metabolism and is used, usually in combination with other drugs, in the treatment of or in remission maintenance programs for leukemia.Methotrexate
an antineoplastic antimetabolite with immunosuppressant properties. it is an inhibitor of tetrahydrofolate dehydrogenase and prevents the formation of tetrahydrofolate, necessary for synthesis of thymidylate, an essential component of dna.Mitobronitol
brominated analog of mannitol which is an antineoplastic agent appearing to act as an alkylating agent.Mitoguazone
antineoplastic agent effective against myelogenous leukemia in experimental animals. also acts as an inhibitor of animal s-adenosylmethionine decarboxylase.Mitolactol
alkylating antineoplastic toxic to bone marrow; used in breast cancer, also in combination with other drugs.Mitomycin
an antineoplastic antibiotic produced by streptomyces caespitosus. it is one of the bi- or tri-functional alkylating agents causing cross-linking of dna and inhibition of dna synthesis.Mitomycins
a group of methylazirinopyrroloindolediones obtained from certain streptomyces strains. they are very toxic antibiotics used as antineoplastic agents in some solid tumors. porfiromycin and mitomycin are the most useful members of the group.Mitotane
a derivative of the insecticide dichlorodiphenyldichloroethane that specifically inhibits cells of the adrenal cortex and their production of hormones. it is used to treat adrenocortical tumors and causes cns damage, but no bone marrow depression.Mitoxantrone
an anthracenedione-derived antineoplastic agent.Mopidamol
a phosphodiesterase inhibitor which inhibits platelet aggregation. formerly used as an antineoplastic.Nimustine
antineoplastic agent especially effective against malignant brain tumors. the resistance which brain tumor cells acquire to the initial effectiveness of this drug can be partially overcome by the simultaneous use of membrane-modifying agents such as reserpine, calcium antagonists such as nicardipine or verapamil, or the calmodulin inhibitor, trifluoperazine. the drug has also been used in combination with other antineoplastic agents or with radiotherapy for the treatment of various neoplasms.Pentostatin
a potent inhibitor of adenosine deaminase. the drug induces apoptosis of lymphocytes, and is used in the treatment of many lymphoproliferative malignancies, particularly hairy cell leukemia. it is also synergistic with some other antineoplastic agents and has immunosuppressive activity.Peplomycin
an antineoplastic agent derived from bleomycin.Pipobroman
an antineoplastic agent that acts by alkylation.Plicamycin
a tricyclic pentaglycosidic antibiotic from streptomyces strains that inhibits rna and protein synthesis by adhering to dna. it is used as a fluorescent dye and as an antineoplastic agent, especially in bone and testicular tumors. plicamycin is also used to reduce hypercalcemia, especially that due to malignancies.Porfiromycin
toxic antibiotic of the mitomycin group, obtained from mitomycin and also from streptomyces ardus and other species. it is proposed as an antineoplastic agent, with some antibiotic properties.Prednimustine
ester of chlorambucil and prednisolone used as a combination alkylating agent and synthetic steroid to treat various leukemias and other neoplasms. it causes gastrointestinal and bone marrow toxicity.Procarbazine
an antineoplastic agent used primarily in combination with mechlorethamine, vincristine, and prednisone (the mopp protocol) in the treatment of hodgkin's disease.Dexrazoxane
the (+)-enantiomorph of razoxane.Razoxane
an antimitotic agent with immunosuppressive properties.Semustine
4-methyl derivative of lomustine; (ccnu). an antineoplastic agent which functions as an alkylating agent.Diabetes Mellitus, Experimental
diabetes mellitus induced experimentally by administration of various diabetogenic agents or by pancreatectomy.Streptozocin
an antibiotic that is produced by stretomyces achromogenes. it is used as an antineoplastic agent and to induce diabetes in experimental animals.Tegafur
congener of fluorouracil with comparable antineoplastic action. it has been suggested especially for the treatment of breast neoplasms.Teniposide
a semisynthetic derivative of podophyllotoxin that exhibits antitumor activity. teniposide inhibits dna synthesis by forming a complex with topoisomerase ii and dna. this complex induces breaks in double stranded dna and prevents repair by topoisomerase ii binding. accumulated breaks in dna prevent cells from entering into the mitotic phase of the cell cycle, and lead to cell death. teniposide acts primarily in the g2 and s phases of the cycle.Thalidomide
a piperidinyl isoindole originally introduced as a non-barbiturate hypnotic, but withdrawn from the market due to teratogenic effects. it has been reintroduced and used for a number of immunological and inflammatory disorders. thalidomide displays immunosuppressive and anti-angiogenic activity. it inhibits release of tumor necrosis factor-alpha from monocytes, and modulates other cytokine action.Thioguanine
an antineoplastic compound which also has antimetabolite action. the drug is used in the therapy of acute leukemia.Thiotepa
a very toxic alkylating antineoplastic agent also used as an insect sterilant. it causes skin, gastrointestinal, cns, and bone marrow damage. according to the fourth annual report on carcinogens (ntp 85-002, 1985), thiotepa may reasonably be anticipated to be a carcinogen (merck index, 11th ed).Triaziquone
alkylating antineoplastic agent used mainly for ovarian tumors. it is toxic to skin, gastrointestinal tract, bone marrow and kidneys.Triethylenemelamine
toxic alkylating agent used in industry; also as antineoplastic and research tool to produce chromosome aberrations and cancers.Triethylenephosphoramide
an insect chemosterilant and an antineoplastic agent.Trimetrexate
a nonclassical folic acid inhibitor through its inhibition of the enzyme dihydrofolate reductase. it is being tested for efficacy as an antineoplastic agent and as an antiparasitic agent against pneumocystis pneumonia in aids patients. myelosuppression is its dose-limiting toxic effect.Uracil Mustard
nitrogen mustard derivative of uracil. it is a alkylating antineoplastic agent that is used in lymphatic malignancies, and causes mainly gastrointestinal and bone marrow damage.Urethane
antineoplastic agent that is also used as a veterinary anesthetic. it has also been used as an intermediate in organic synthesis. urethane is suspected to be a carcinogen.Vinblastine
antitumor alkaloid isolated from vinca rosea. (merck, 11th ed.)Vincamine
a major alkaloid of vinca minor l., apocynaceae. it has been used therapeutically as a vasodilator and antihypertensive agent, particularly in cerebrovascular disorders.Vincristine
an antitumor alkaloid isolated from vinca rosea. (merck, 11th ed.)Vindesine
vinblastine derivative with antineoplastic activity against cancer. major side effects are myelosuppression and neurotoxicity. vindesine is used extensively in chemotherapy protocols (antineoplastic combined chemotherapy protocols).Zinostatin
an enediyne that alkylates dna and rna like mitomycin does, so it is cytotoxic.
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 primarily systemic and hematological agents, not elsewhere classified (T45). Use the following options for the aplicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
Convert T45.1X4A to ICD-9-CM
- ICD-9-CM Code: 963.1 - Pois-antineopl/immunosup
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: E980.4 - Undet pois-med agnt NEC
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 T45.1X4 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.
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.