2024 ICD-10-CM Diagnosis Code T40.2X4

Specific Coding Applicable to Poisoning by other opioids, undetermined

Non-specific codes like T40.2X4 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10-CM codes with a higher level of specificity when coding for poisoning by other opioids, undetermined:

Clinical Information

• Codeine

  an opioid analgesic related to morphine but with less potent analgesic properties and mild sedative effects. it also acts centrally to suppress cough.

• Dextrorphan

  dextro form of levorphanol. it acts as a noncompetitive nmda receptor antagonist, among other effects, and has been proposed as a neuroprotective agent. it is also a metabolite of dextromethorphan.

• Dihydromorphine

  a semisynthetic analgesic used in the study of narcotic receptors.

• Ethylmorphine

  a narcotic analgesic and antitussive. it is metabolized in the liver by ethylmorphine-n-demethylase and used as an indicator of liver function.

• Ethylmorphine-N-Demethylase

  a drug-metabolizing enzyme of the hepatic microsomal oxidase system which catalyzes the oxidation of the n-methyl group of ethylmorphine with the formation of formaldehyde.

• Etorphine

  a narcotic analgesic morphinan used as a sedative in veterinary practice.

• Hydrocodone

  narcotic analgesic related to codeine, but more potent and more addicting by weight. it is used also as cough suppressant.

• Hydromorphone

  an opioid analgesic made from morphine and used mainly as an analgesic. it has a shorter duration of action than morphine.

• Glucuronosyltransferase

  a family of enzymes accepting a wide range of substrates, including phenols, alcohols, amines, and fatty acids. they function as drug-metabolizing enzymes that catalyze the conjugation of udpglucuronic acid to a variety of endogenous and exogenous compounds. ec 2.4.1.17.

• Morphine

  the principal alkaloid in opium and the prototype opiate analgesic and narcotic. morphine has widespread effects in the central nervous system and on smooth muscle.

• Morphine Dependence

  strong dependence, both physiological and emotional, upon morphine.

• Morphine Derivatives

  analogs or derivatives of morphine.

• Receptors, Opioid, mu

  a class of opioid receptors recognized by its pharmacological profile. mu opioid receptors bind, in decreasing order of affinity, endorphins, dynorphins, met-enkephalin, and leu-enkephalin. they have also been shown to be molecular receptors for morphine.

• Oxycodone

  a semisynthetic derivative of codeine.

• Oxymorphone

  an opioid analgesic with actions and uses similar to those of morphine, apart from an absence of cough suppressant activity. it is used in the treatment of moderate to severe pain, including pain in obstetrics. it may also be used as an adjunct to anesthesia. (from martindale, the extra pharmacopoeia, 30th ed, p1092)

• Promedol

  a narcotic analgesic similar to meperidine; it exists in four stereoisomers, two of which, the beta (isopromedol) and the gamma (trimeperidine) are active.

• Thebaine

  a drug that is derived from opium, which contains from 0.3-1.5% thebaine depending on its origin. it produces strychnine-like convulsions rather than narcosis. it may be habit-forming and is a controlled substance (opiate) listed in the u.s. code of federal regulations, title 21 part 1308.12 (1985). (from merck index, 11th ed)

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 narcotics and psychodysleptics [hallucinogens] (T40). Use the following options for the aplicable episode of care:

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

Table of Drugs and Chemicals

The 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

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.

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.