2024 ICD-10-CM Diagnosis Code T38.1X2S

Poisoning by thyroid hormones and substitutes, intentional self-harm, sequela

ICD-10-CM Code:
T38.1X2S
ICD-10 Code for:
Poisoning by thyroid hormones and sub, self-harm, 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 hormones and their synthetic substitutes and antagonists, not elsewhere classified
        (T38)

T38.1X2S is a billable diagnosis code used to specify a medical diagnosis of poisoning by thyroid hormones and substitutes, intentional self-harm, 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.

T38.1X2S 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 thyroid hormones and substitutes intentional self-harm. 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:

  • Intentional levothyroxine poisoning
  • Intentional liothyronine overdose
  • Intentional liothyronine poisoning
  • Intentional thyroglobulin poisoning
  • Intentional thyroxin overdose
  • Intentional thyroxin poisoning
  • Levothyroxine poisoning
  • Liothyronine overdose
  • Poisoning by liothyronine
  • Poisoning by liothyronine
  • Poisoning by thyroglobulin
  • Thyroid hormone overdose
  • Thyroid hormone overdose

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

  • Correspondence as Topic

    works on written communication between persons or between institutions or organizations.
  • Histiocytosis, Langerhans-Cell

    a group of disorders resulting from the abnormal proliferation of and tissue infiltration by langerhans cells which can be detected by their characteristic birbeck granules (x bodies), or by monoclonal antibody staining for their surface cd1 antigens. langerhans-cell granulomatosis can involve a single organ, or can be a systemic disorder.
  • Letter

    work consisting of written or printed communication between individuals or between persons and representatives of corporate bodies. the correspondence may be personal or professional. in medical and other scientific publications the letter is usually from one or more authors to the editor of the journal or book publishing the item being commented upon or discussed. letter is often accompanied by comment.
  • Thyroglobulin

  • Iodide Peroxidase

    a hemeprotein that catalyzes the oxidation of the iodide radical to iodine with the subsequent iodination of many organic compounds, particularly proteins. ec 1.11.1.8.
  • Receptors, Thyroid Hormone

    specific high affinity binding proteins for thyroid hormones in target cells. they are usually found in the nucleus and regulate dna transcription. these receptors are activated by hormones that leads to transcription, cell differentiation, and growth suppression. thyroid hormone receptors are encoded by two genes (genes, erba): erba-alpha and erba-beta for alpha and beta thyroid hormone receptors, respectively.
  • Thyroxine

    the major hormone derived from the thyroid gland. thyroxine is synthesized via the iodination of tyrosines (monoiodotyrosine) and the coupling of iodotyrosines (diiodotyrosine) in the thyroglobulin. thyroxine is released from thyroglobulin by proteolysis and secreted into the blood. thyroxine is peripherally deiodinated to form triiodothyronine which exerts a broad spectrum of stimulatory effects on cell metabolism.
  • Thyroxine-Binding Globulin

    a thyroid hormone transport protein found in serum. it binds about 75% of circulating thyroxine and 70% of circulating triiodothyronine.
  • Thyroxine-Binding Proteins

    blood proteins that bind to thyroid hormones such as thyroxine and transport them throughout the circulatory system.
  • Triiodothyronine

    a t3 thyroid hormone normally synthesized and secreted by the thyroid gland in much smaller quantities than thyroxine (t4). most t3 is derived from peripheral monodeiodination of t4 at the 5' position of the outer ring of the iodothyronine nucleus. the hormone finally delivered and used by the tissues is mainly t3.
  • Triiodothyronine, Reverse

    a metabolite of thyroxine, formed by the peripheral enzymatic monodeiodination of t4 at the 5 position of the inner ring of the iodothyronine nucleus.

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 hormones and their synthetic substitutes and antagonists, not elsewhere classified (T38). Use the following options for the aplicable episode of care:

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

Present on Admission (POA)

T38.1X2S 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 T38.1X2S 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: E959 - Late eff of self-injury
    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 T38.1X2 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
CytomelT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
DetrothyronineT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
DextrothyroxinT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
Dextrothyroxine sodiumT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
EuthroidT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
I-thyroxine sodiumT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
LetterT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
LevoidT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
LevothyroxineT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
Levothyroxine
  »sodium
T38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
LiothyronineT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
LiotrixT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
ProloidT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
SynthroidT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
ThyroglobulinT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
Thyroid (hormone)T38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
ThyrolarT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
ThyroxineT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
TiratricolT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
TitroidT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6
TriiodothyronineT38.1X1T38.1X2T38.1X3T38.1X4T38.1X5T38.1X6

Patient Education


Hormones

Hormones are your body's chemical messengers. They travel in your bloodstream to tissues or organs. They work slowly, over time, and affect many different processes, including:

  • Growth and development
  • Metabolism - how your body gets energy from the foods you eat
  • Sexual function
  • Reproduction
  • Mood

Endocrine glands, which are special groups of cells, make hormones. The major endocrine glands are the pituitary, pineal, thymus, thyroid, adrenal glands, and pancreas. In addition, men produce hormones in their testes and women produce them in their ovaries.

Hormones are powerful. It takes only a tiny amount to cause big changes in cells or even your whole body. That is why too much or too little of a certain hormone can be serious. Laboratory tests can measure the hormone levels in your blood, urine, or saliva. Your health care provider may perform these tests if you have symptoms of a hormone disorder. Home pregnancy tests are similar - they test for pregnancy hormones in your urine.


[Learn More in MedlinePlus]

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.


[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.