2026 ICD-10-CM Diagnosis Code T38.3X4APoisoning by insulin and oral hypoglycemic [antidiabetic] drugs, undetermined, initial encounter
T38.3X4A is a billable ICD-10-CM diagnosis code for poisoning by insulin and oral hypoglycemic [antidiabetic] drugs, undetermined, initial encounter. The 7th character A marks it as an initial encounter code, used while the patient is receiving active treatment. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 917 through 918. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under External cause codes: intent of injury, undetermined; External cause codes: poisoning by drug; and Poisoning by drugs, initial encounter.
Code Identity
Code Classification
Coding GuidelinesGuidance
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 applicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2026, published by CMS and the National Center for Health Statistics.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Acetohexamide
a sulfonylurea hypoglycemic agent that is metabolized in the liver to 1-hydrohexamide.Buformin
an oral hypoglycemic agent that inhibits gluconeogenesis, increases glycolysis, and decreases glucose oxidation.Carbutamide
a sulfonylurea antidiabetic agent with similar actions and uses to chlorpropamide. (from martindale, the extra pharmacopoeia, 30th ed, p277)Chlorpropamide
a sulfonylurea hypoglycemic agent used in the treatment of non-insulin-dependent diabetes mellitus not responding to dietary modification. (from martindale, the extra pharmacopoeia, 30th ed, p277)Gliclazide
an oral sulfonylurea hypoglycemic agent which stimulates insulin secretion.Glipizide
an oral hypoglycemic agent which is rapidly absorbed and completely metabolized.Glucagon
a 29-amino acid pancreatic peptide derived from proglucagon which is also the precursor of intestinal glucagon-like peptides. glucagon is secreted by pancreatic alpha cells and plays an important role in regulation of blood glucose concentration, ketone metabolism, and several other biochemical and physiological processes. (from gilman et al., goodman and gilman's the pharmacological basis of therapeutics, 9th ed, p1511)Glucagon-Like Peptide 1
a peptide of 36 or 37 amino acids that is derived from proglucagon and mainly produced by the intestinal l cells. glp-1(1-37 or 1-36) is further n-terminally truncated resulting in glp-1(7-37) or glp-1-(7-36) which can be amidated. these glp-1 peptides are known to enhance glucose-dependent insulin release, suppress glucagon release and gastric emptying, lower blood glucose, and reduce food intake.Glucagon-Like Peptide 2
a 33-amino acid peptide derived from the c-terminal of proglucagon and mainly produced by the intestinal l cells. it stimulates intestinal mucosal growth and decreased apoptosis of enterocytes. glp-2 enhances gastrointestinal function and plays an important role in nutrient homeostasis.Glucagon-Like Peptide Receptors
g-protein coupled cell surface receptors that bind glucagon-like peptides and are expressed by cells in pancreatic, intestinal, and neural tissues. these receptors regulate cellular responses to blood glucose, insulin, and inflammation signals.Glucagon-Like Peptide-1 Receptor
a receptor for glucagon-like peptide 1 (glp-1) expressed primarily on the surface of beta and ductal exocrine cells of the pancreas, as well as cells of other tissues. glp-1 acts through glp-1r to potentiate signaling in pancreatic cells in response to glucose-stimulated insulin secretion (gsis).Glucagon-Like Peptide-1 Receptor Agonists
compounds that stimulate the activity of glucagon-like peptide-1 receptor. glucagon-like peptide-1 receptor agonists are used to treat type 2 diabetes and obesity.Glucagon-Like Peptide-2 Receptor
a receptor for glucagon-like peptide 2 (glp-2) that is expressed on the surface of intestinal cells as well as neural cells. glp-2 and other peptides act through glp-2r to regulate cellular responses to blood glucose, inflammation, and food intake.Glucagon-Like Peptides
peptides derived from proglucagon which is also the precursor of pancreatic glucagon. despite expression of proglucagon in multiple tissues, the major production site of glucagon-like peptides (glps) is the intestinal l cells. glps include glucagon-like peptide 1, glucagon-like peptide 2, and the various truncated forms.Glucagonoma
an almost always malignant glucagon-secreting tumor derived from the pancreatic alpha cells. it is characterized by a distinctive migratory erythema; weight loss; stomatitis; glossitis; diabetes mellitus; hypoaminoacidemia; and normochromic normocytic anemia.Glucagon-Secreting Cells
a type of pancreatic cell representing about 5-20% of the islet cells. alpha cells secrete glucagon.Proglucagon
the common precursor polypeptide of pancreatic glucagon and intestinal glucagon-like peptides. proglucagon is the 158-amino acid segment of preproglucagon without the n-terminal signal sequence. proglucagon is expressed in the pancreas; intestines; and the central nervous system. posttranslational processing of proglucagon is tissue-specific yielding numerous bioactive peptides.Receptors, Glucagon
cell surface receptors that bind glucagon with high affinity and trigger intracellular changes which influence the behavior of cells. activation of glucagon receptors causes a variety of effects; the best understood is the initiation of a complex enzymatic cascade in the liver which ultimately increases the availability of glucose to body organs.Glyburide
an antidiabetic sulfonylurea derivative with actions like those of chlorpropamideMetformin
a biguanide hypoglycemic agent used in the treatment of non-insulin-dependent diabetes mellitus not responding to dietary modification. metformin improves glycemic control by improving insulin sensitivity and decreasing intestinal absorption of glucose. (from martindale, the extra pharmacopoeia, 30th ed, p289)Phenformin
a biguanide hypoglycemic agent with actions and uses similar to those of metformin. although it is generally considered to be associated with an unacceptably high incidence of lactic acidosis, often fatal, it is still available in some countries. (from martindale, the extra pharmacopoeia, 30th ed, p290)Tolazamide
a sulphonylurea hypoglycemic agent with actions and uses similar to those of chlorpropamide.
Table of Drugs and ChemicalsClinical
Substances in the Table of Drugs and Chemicals that reference this code family. Always confirm in the Tabular List before coding.
| Substance | Accidental | Self-harm | Assault | Undetermined | Adverse Effect | Underdosing |
|---|---|---|---|---|---|---|
| Acetohexamide | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Antidiabetic NEC | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Antidiabetic NEC::biguanide | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Antidiabetic NEC::biguanide::and sulfonyl combined | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Antidiabetic NEC::combined | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Antidiabetic NEC::sulfonylurea | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Biguanide derivatives, oral | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Buformin | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Carbutamide | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Chlorpropamide | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| DBI | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Diabinese | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Dymelor | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Extended insulin zinc suspension | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Glibenclamide | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Glibornuride | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Gliclazide | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Glimidine | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Glipizide | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Gliquidone | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Glisolamide | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Glisoxepide | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Globin zinc insulin | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Glucagon | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Glyburide | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Glyclopyramide | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Glycyclamide | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Glymidine sodium | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Iletin | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Insular tissue extract | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Insulin (amorphous) (globin) (isophane) (Lente) (NPH) (Semilente) (Ultralente) | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Insulin (amorphous) (globin) (isophane) (Lente) (NPH) (Semilente) (Ultralente)::defalan | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Insulin (amorphous) (globin) (isophane) (Lente) (NPH) (Semilente) (Ultralente)::human | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Insulin (amorphous) (globin) (isophane) (Lente) (NPH) (Semilente) (Ultralente)::injection, soluble | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Insulin (amorphous) (globin) (isophane) (Lente) (NPH) (Semilente) (Ultralente)::injection, soluble::biphasic | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Insulin (amorphous) (globin) (isophane) (Lente) (NPH) (Semilente) (Ultralente)::intermediate acting | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Insulin (amorphous) (globin) (isophane) (Lente) (NPH) (Semilente) (Ultralente)::protamine zinc | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Insulin (amorphous) (globin) (isophane) (Lente) (NPH) (Semilente) (Ultralente)::slow acting | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Insulin (amorphous) (globin) (isophane) (Lente) (NPH) (Semilente) (Ultralente)::zinc | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Insulin (amorphous) (globin) (isophane) (Lente) (NPH) (Semilente) (Ultralente)::zinc::protamine injection | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Insulin (amorphous) (globin) (isophane) (Lente) (NPH) (Semilente) (Ultralente)::zinc::suspension (amorphous) (crystalline) | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Isophane insulin | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Lente Iletin (insulin) | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Metformin | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Neutral insulin injection | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| NPH Iletin (insulin) | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Orinase | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Phenformin | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Phenylethylbiguanide | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| PZI | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Sulfonylurea derivatives, oral | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Tolazamide | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
| Tolbutamide (sodium) | T38.3X1 | T38.3X2 | T38.3X3 | T38.3X4 | T38.3X5 | T38.3X6 |
Patient EducationClinical
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Convert T38.3X4A to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About T38.3X4AOverview
Is T38.3X4A a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report poisoning by insulin and oral hypoglycemic [antidiabetic] drugs, undetermined, initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character A in T38.3X4A mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for poisoning by insulin and oral hypoglycemic [antidiabetic] drugs, undetermined, such as an emergency visit or first evaluation.
What MS-DRG does T38.3X4A group to?
When poisoning by insulin and oral hypoglycemic [antidiabetic] drugs, undetermined, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 917, 918, with relative weights from 0.8571 to 1.5684 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of T38.3X4A?
Under the General Equivalence Mappings, poisoning by insulin and oral hypoglycemic [antidiabetic] drugs, undetermined, initial encounter converts to ICD-9-CM 962.3 (poison-insulin/antidiab) and E980.4 (undet pois-med agnt NEC). The mapping is approximate, so confirm the match fits the documentation.
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.
