2027 ICD-10-CM Diagnosis Code T38.3X4SPoisoning by insulin and oral hypoglycemic [antidiabetic] drugs, undetermined, sequela

ICD-10-CM T38.3X4S

CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

T38.3X4S is a billable ICD-10-CM diagnosis code for poisoning by insulin and oral hypoglycemic [antidiabetic] drugs, undetermined, sequela. The 7th character S marks it as a sequela code, which reports a problem that remains after the original condition has resolved. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 922 through 923. The code is exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Poisoning/toxic effect/adverse effects/underdosing, sequela.

Code Identity

ICD-10-CM Code

T38.3X4S

Billable Status

Yes — Valid for Submission

Code Describes

Poisoning by insulin and oral hypoglycemic [antidiabetic] drugs, undetermined, sequela

Short Description

Poisn by insulin and oral hypoglycemic drugs, undet, sequela

Parent Code

T38.3X4

Poisoning by insulin and oral hypoglycemic [antidiabetic] drugs, undetermined

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes

SectionT36-T50Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances

CategoryT38Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified

This CodeT38.3X4SPoisoning by insulin and oral hypoglycemic [antidiabetic] drugs, undetermined, sequela

Present on Admission (POA)Billing

T38.3X4S is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances (T36-T50).

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 2027, published by CMS and the National Center for Health Statistics.

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to T38.3X4S: its own notes plus those printed at T38, block T36-T50, and Chapter 19. A note printed at a category, block or chapter applies to every code under it.