2024 ICD-10-CM Diagnosis Code T48.4X1A

Approximate Synonyms

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

• Accidental acetylcysteine overdose
• Accidental acetylcysteine poisoning
• Accidental guaifenesin poisoning
• Accidental terpin hydrate poisoning
• Acetylcysteine overdose
• Guaifenesin poisoning
• Liquorice overdose
• Poisoning by acetylcysteine
• Poisoning by terpin hydrate

Clinical Information

• Acetylcysteine

  the n-acetyl derivative of cysteine. it is used as a mucolytic agent to reduce the viscosity of mucous secretions. it has also been shown to have antiviral effects in patients with hiv due to inhibition of viral stimulation by reactive oxygen intermediates.

• Ambroxol

  a metabolite of bromhexine that stimulates mucociliary action and clears the air passages in the respiratory tract. it is usually administered as the hydrochloride.

• Bromhexine

  a mucolytic agent used in the treatment of respiratory disorders associated with viscid or excessive mucus. (from martindale, the extra pharmacopoeia, 30th ed, p744)

• Glycyrrhizic Acid

  a widely used anti-inflammatory agent isolated from the licorice root. it is metabolized to glycyrrhetinic acid, which inhibits 11-beta-hydroxysteroid dehydrogenases and other enzymes involved in the metabolism of corticosteroids. therefore, glycyrrhizic acid, which is the main and sweet component of licorice, has been investigated for its ability to cause hypermineralocorticoidism with sodium retention and potassium loss, edema, increased blood pressure, as well as depression of the renin-angiotensin-aldosterone system.

• Guaifenesin

  an expectorant that also has some muscle relaxing action. it is used in many cough preparations.

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 agents primarily acting on smooth and skeletal muscles and the respiratory system (T48). Use the following options for the aplicable episode of care:

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

T48.4X1A is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Convert T48.4X1A to ICD-9-CM

• ICD-9-CM Code: 975.5 - Poisoning-expectorants
  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: E858.6 - Acc poisn-muscl/resp agt
  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 T48.4X1 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

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

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.