2024 ICD-10-CM Diagnosis Code T40.493D

Poisoning by other synthetic narcotics, assault, subsequent encounter

ICD-10-CM Code:
T40.493D
ICD-10 Code for:
Poisoning by other synthetic narcotics, assault, subs
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 narcotics and psychodysleptics [hallucinogens]
        (T40)

T40.493D is a billable diagnosis code used to specify a medical diagnosis of poisoning by other synthetic narcotics, assault, subsequent encounter. 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.

T40.493D is a subsequent encounter code, includes a 7th character and should be used after the patient has completed active treatment for a condition like poisoning by other synthetic narcotics assault. According to ICD-10-CM Guidelines a "subsequent encounter" occurs when the patient is receiving routine care for the condition during the healing or recovery phase of treatment. Subsequent diagnosis codes are appropriate during the recovery phase, no matter how many times the patient has seen the provider for this condition. If the provider needs to adjust the patient's care plan due to a setback or other complication, the encounter becomes active again.

Clinical Classification

Clinical CategoryCCSR Category CodeInpatient Default CCSROutpatient Default CCSR
Opioid-related disorders; subsequent encounterMBD028N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis.N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.
Poisoning by drugs, subsequent encounterINJ059Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

Clinical Information

  • Alphaprodine

    an opioid analgesic chemically related to and with an action resembling that of meperidine, but more rapid in onset and of shorter duration. it has been used in obstetrics, as pre-operative medication, for minor surgical procedures, and for dental procedures. (from martindale, the extra pharmacopoeia, 30th ed, p1067)
  • Buprenorphine

    a derivative of the opioid alkaloid thebaine that is a more potent and longer lasting analgesic than morphine. it appears to act as a partial agonist at mu and kappa opioid receptors and as an antagonist at delta receptors. the lack of delta-agonist activity has been suggested to account for the observation that buprenorphine tolerance may not develop with chronic use.
  • Buprenorphine, Naloxone Drug Combination

    a pharmaceutical preparation that combines buprenorphine, an opioid analgesics with naloxone, a narcotic antagonists to reduce the potential for narcotic dependence in the treatment of pain. it may also be used for opioid substitution therapy.
  • Butorphanol

    a synthetic morphinan analgesic with narcotic antagonist action. it is used in the management of severe pain.
  • Dextromoramide

    an opioid analgesic structurally related to methadone and used in the treatment of severe pain. (from martindale, the extra pharmacopoeia, 30th ed, p1070)
  • Dextropropoxyphene

    a narcotic analgesic structurally related to methadone. only the dextro-isomer has an analgesic effect; the levo-isomer appears to exert an antitussive effect.
  • Levopropoxyphene

    a propionate derivative that is used to suppress coughing.
  • Levorphanol

    a narcotic analgesic that may be habit-forming. it is nearly as effective orally as by injection.
  • Meperidine

    a narcotic analgesic that can be used for the relief of most types of moderate to severe pain, including postoperative pain and the pain of labor. prolonged use may lead to dependence of the morphine type; withdrawal symptoms appear more rapidly than with morphine and are of shorter duration.
  • Nalbuphine

    a narcotic used as a pain medication. it appears to be an agonist at kappa receptors and an antagonist or partial agonist at mu receptors.
  • Pentazocine

    the first mixed agonist-antagonist analgesic to be marketed. it is an agonist at the kappa and sigma opioid receptors and has a weak antagonist action at the mu receptor. (from ama drug evaluations annual, 1991, p97)
  • Phenazocine

    an opioid analgesic with actions and uses similar to morphine. (from martindale, the extra pharmacopoeia, 30th ed, p1095)
  • Phenoperidine

    a narcotic analgesic partly metabolized to meperidine in the liver. it is similar to morphine in action and used for neuroleptanalgesia, usually with droperidol.
  • Tilidine

    an opioid analgesic used similarly to morphine in the control of moderate to severe pain. (from martindale, the extra pharmacopoeia, 30th ed, p1097)

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

Present on Admission (POA)

T40.493D 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

Replacement Code

T40493D replaces the following previously assigned ICD-10-CM code(s):

  • T40.4X3D - Poisoning by other synthetic narcotics, assault, subs encntr

Table of Drugs and Chemicals

The parent code T40.493 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
AlphaprodineT40.491T40.492T40.493T40.494T40.495T40.496
AnileridineT40.491T40.492T40.493T40.494T40.495T40.496
BezitramideT40.491T40.492T40.493T40.494T40.495T40.496
BuprenorphineT40.491T40.492T40.493T40.494T40.495T40.496
ButorphanolT40.491T40.492T40.493T40.494T40.495T40.496
DextromoramideT40.491T40.492T40.493T40.494  
Dextromoramide
  »topical
T40.491T40.492T40.493T40.494  
DextropropoxypheneT40.491T40.492T40.493T40.494T40.495T40.496
DipipanoneT40.491T40.492T40.493T40.494  
EptazocineT40.491T40.492T40.493T40.494T40.495T40.496
EthoheptazineT40.491T40.492T40.493T40.494T40.495T40.496
IsonipecaineT40.491T40.492T40.493T40.494T40.495T40.496
KetobemidoneT40.491T40.492T40.493T40.494  
LevopropoxypheneT40.491T40.492T40.493T40.494T40.495T40.496
LevorphanolT40.491T40.492T40.493T40.494T40.495T40.496
MeperidineT40.491T40.492T40.493T40.494T40.495T40.496
NalbuphineT40.491T40.492T40.493T40.494T40.495T40.496
PentazocineT40.491T40.492T40.493T40.494T40.495T40.496
PethidineT40.491T40.492T40.493T40.494T40.495T40.496
PhenazocineT40.491T40.492T40.493T40.494T40.495T40.496
PhenoperidineT40.491T40.492T40.493T40.494  
PiritramideT40.491T40.492T40.493T40.494  
ProfadolT40.491T40.492T40.493T40.494T40.495T40.496
PropoxypheneT40.491T40.492T40.493T40.494T40.495T40.496
TilidineT40.491T40.492T40.493T40.494  

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 - Code Added, effective from 10/1/2020 through 9/30/2021

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.