2024 ICD-10-CM Diagnosis Code T49.8X4S

Poisoning by other topical agents, undetermined, sequela

ICD-10-CM Code:
T49.8X4S
ICD-10 Code for:
Poisoning by other topical agents, undetermined, 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 topical agents primarily affecting skin and mucous membrane and by ophthalmological, otorhinorlaryngological and dental drugs
        (T49)

T49.8X4S is a billable diagnosis code used to specify a medical diagnosis of poisoning by other topical agents, undetermined, 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.

T49.8X4S 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 other topical agents undetermined. 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

  • Cosmetics

    substances intended to be applied to the human body for cleansing, beautifying, promoting attractiveness, or altering the appearance without affecting the body's structure or functions. included in this definition are skin creams, lotions, perfumes, lipsticks, fingernail polishes, eye and facial makeup preparations, permanent waves, hair colors, toothpastes, and deodorants, as well as any material intended for use as a component of a cosmetic product. (u.s. food & drug administration center for food safety & applied nutrition office of cosmetics fact sheet (web page) feb 1995)
  • Hair Preparations

    hair grooming, cleansing and modifying products meant for topical application to hair, usually human. they include sprays, bleaches, dyes, conditioners, rinses, shampoos, nutrient lotions, etc.
  • Acidosis, Lactic

    acidosis caused by accumulation of lactic acid more rapidly than it can be metabolized. it may occur spontaneously or in association with diseases such as diabetes mellitus; leukemia; or liver failure.
  • Lactic Acid

    a normal intermediate in the fermentation (oxidation, metabolism) of sugar. the concentrated form is used internally to prevent gastrointestinal fermentation. (from stedman, 26th ed)
  • Lactobacillales

    an order of gram-positive bacteria in the class bacilli, that have the ability to ferment sugars to lactic acid. they are widespread in nature and commonly used to produce fermented foods.
  • Pyruvate Carboxylase Deficiency Disease

    an autosomal recessive metabolic disorder caused by absent or decreased pyruvate carboxylase activity, the enzyme that regulates gluconeogenesis, lipogenesis, and neurotransmitter synthesis. clinical manifestations include lactic acidosis, seizures, respiratory distress, marked psychomotor delay, periodic hypoglycemia, and hypotonia. the clinical course may be similar to leigh disease. (from am j hum genet 1998 jun;62(6):1312-9)
  • Pyruvate Dehydrogenase Complex Deficiency Disease

    an inherited metabolic disorder caused by deficient enzyme activity in the pyruvate dehydrogenase complex, resulting in deficiency of acetyl coa and reduced synthesis of acetylcholine. two clinical forms are recognized: neonatal and juvenile. the neonatal form is a relatively common cause of lactic acidosis in the first weeks of life and may also feature an erythematous rash. the juvenile form presents with lactic acidosis, alopecia, intermittent ataxia; seizures; and an erythematous rash. (from j inherit metab dis 1996;19(4):452-62) autosomal recessive and x-linked forms are caused by mutations in the genes for the three different enzyme components of this multisubunit pyruvate dehydrogenase complex. one of the mutations at xp22.2-p22.1 in the gene for the e1 alpha component of the complex leads to leigh disease.
  • Podophyllotoxin

    a lignan (lignans) found in podophyllin resin from the roots of podophyllum plants. it is a potent spindle poison, toxic if taken internally, and has been used as a cathartic. it is very irritating to skin and mucous membranes, has keratolytic actions, has been used to treat warts and keratoses, and may have antineoplastic properties, as do some of its congeners and derivatives.

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 topical agents primarily affecting skin and mucous membrane and by ophthalmological, otorhinorlaryngological and dental drugs (T49). Use the following options for the aplicable episode of care:

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

Present on Admission (POA)

T49.8X4S 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 T49.8X4S 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: E989 - Late eff inj-undet circ
    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 T49.8X4 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
BenoquinT49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
Cantharides, cantharidin, cantharisT49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
Cell stimulants and proliferantsT49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
ChloresiumT49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
Cosmetic preparationT49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
CosmeticsT49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
Demelanizing agentsT49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
Deodorant spray (feminine hygiene)T49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
ElaseT49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
GelfilmT49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
HeetT49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
Irrigating fluid (vaginal)T49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
Irrigating fluid (vaginal)
  »eye
T49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
Lactic acidT49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
Local action drug NECT49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
Lytta (vitatta)T49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
NonoxinolT49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
Nonylphenoxy (polyethoxy-ethanol)T49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
Octoxinol (9)T49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
PodophyllotoxinT49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
Preparation HT49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
SantylT49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
Scarlet redT49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
Spanish flyT49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
SpermicideT49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
Tosylchloramide sodiumT49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6
Vaginal contraceptivesT49.8X1T49.8X2T49.8X3T49.8X4T49.8X5T49.8X6

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.


[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.