2024 ICD-10-CM Diagnosis Code T45.611S

Poisoning by thrombolytic drug, accidental (unintentional), sequela

ICD-10-CM Code:
T45.611S
ICD-10 Code for:
Poisoning by thrombolytic drug, accidental, 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 primarily systemic and hematological agents, not elsewhere classified
        (T45)

T45.611S is a billable diagnosis code used to specify a medical diagnosis of poisoning by thrombolytic drug, accidental (unintentional), 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.

T45.611S 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 thrombolytic drug accidental (unintentional). 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.

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Accidental streptokinase overdose
  • Accidental streptokinase poisoning
  • Accidental urokinase overdose
  • Accidental urokinase poisoning
  • Enzyme overdose
  • Enzyme overdose
  • Enzyme overdose
  • Enzyme overdose
  • Poisoning by streptokinase
  • Poisoning by urokinase
  • Streptokinase overdose
  • Urokinase overdose

Clinical Classification

Clinical Information

  • Anistreplase

    an acylated inactive complex of streptokinase and human lysine-plasminogen. after injection, the acyl group is slowly hydrolyzed, producing an activator that converts plasminogen to plasmin, thereby initiating fibrinolysis. its half-life is about 90 minutes compared to 5 minutes for tpa; (tissue plasminogen activator); 16 minutes for urokinase-type plasminogen activator and 23 minutes for streptokinase. if treatment is initiated within 3 hours of onset of symptoms for acute myocardial infarction, the drug preserves myocardial tissue and left ventricular function and increases coronary artery patency. bleeding complications are similar to other thrombolytic agents.
  • Streptodornase and Streptokinase

    a mixture of the enzymes (streptokinase and streptodornase) produced by hemolytic streptococci. it is used topically on surface lesions and by instillation in closed body cavities to remove clotted blood or fibrinous or purulent accumulations. it is also used as a skin test antigen in evaluating generalized cell-mediated immunodeficiency. (dorland, 27th ed) ec 3.-.
  • Streptokinase

    streptococcal fibrinolysin . an enzyme produced by hemolytic streptococci. it hydrolyzes amide linkages and serves as an activator of plasminogen. it is used in thrombolytic therapy and is used also in mixtures with streptodornase (streptodornase and streptokinase). ec 3.4.-.

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

Present on Admission (POA)

T45.611S 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 T45.611S 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: E929.2 - Late eff acc poisoning
    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 T45.611 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
AlteplaseT45.611T45.612T45.613T45.614T45.615T45.616
AnistreplaseT45.611T45.612T45.613T45.614T45.615T45.616
Fibrinolytic drugT45.611T45.612T45.613T45.614T45.615T45.616
Plasminogen (tissue) activatorT45.611T45.612T45.613T45.614T45.615T45.616
Rt-PAT45.611T45.612T45.613T45.614T45.615T45.616
StreptokinaseT45.611T45.612T45.613T45.614T45.615T45.616
ThrombolysinT45.611T45.612T45.613T45.614T45.615T45.616
UrokinaseT45.611T45.612T45.613T45.614T45.615T45.616

Patient Education


Medication Errors

Medicines treat infectious diseases, prevent problems from chronic diseases, and ease pain. But medicines can also cause harmful reactions if not used correctly. Errors can happen in the hospital, at the health care provider's office, at the pharmacy, or at home. You can help prevent errors by:

  • Knowing your medicines. When you get a prescription, ask the name of the medicine and check to make sure that the pharmacy gave you the right medicine. Make sure that you understand how often you should take the medicine and how long you should take it.
  • Keeping a list of medicines.
    • Write down all of the medicines that you are taking, including the names of your medicines, how much you take, and when you take them. Make sure to include any over-the-counter medicines, vitamins, supplements, and herbs that you take.
    • List the medicines that you are allergic to or that have caused you problems in the past.
    • Take this list with you every time you see a health care provider.
  • Reading medicine labels and following the directions. Don't just rely on your memory - read the medication label every time. Be especially careful when giving medicines to children.
  • Asking questions. If you don't know the answers to these questions, ask your health care provider or pharmacist:
    • Why am I taking this medicine?
    • What are the common side effects?
    • What should I do if I have side effects?
    • When should I stop this medicine?
    • Can I take this medicine with the other medicines and supplements on my list?
    • Do I need to avoid certain foods or alcohol while taking this medicine?

Food and Drug Administration


[Learn More in MedlinePlus]

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.