ICD-10 Code T40.5X6D

Underdosing of cocaine, subsequent encounter

Version 2019 Replaced Code Billable Code Unacceptable Principal Diagnosis POA Exempt
ICD-10:T40.5X6D
Short Description:Underdosing of cocaine, subsequent encounter
Long Description:Underdosing of cocaine, subsequent encounter

Valid for Submission

ICD-10 T40.5X6D is a billable code used to specify a medical diagnosis of underdosing of cocaine, subsequent encounter. The code is valid for the year 2019 for the submission of HIPAA-covered transactions.

Deleted Code

This code was deleted in the 2019 ICD-10 code set with the code(s) listed below. The National Center for Health Statistics (NCHS) has published an update to the ICD-10-CM diagnosis codes which became effective October 1, 2018. This code was replaced for the FY 2019 (October 1, 2018 - September 30, 2019).

  • K59.03 - Drug induced constipation

Code Classification

  • Injury, poisoning and certain other consequences of external causes (S00–T98)
    • Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances (T36-T50)
      • Narcotics and psychodysleptics (T40)

Information for Medical Professionals

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:

  • Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual’s health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.

Convert T40.5X6D to ICD-9

The following crosswalk between ICD-10 to ICD-9 is based based on the General Equivalence Mappings (GEMS) information:

  • - (No Map Flag)

Present on Admission (POA)

T40.5X6D 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.

CMS POA Indicator Options and Definitions
POA Indicator CodePOA Reason 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

Information for Patients


Cocaine

Also called: Blow, C, Coca, Coke, Crack, Flake, Snow

Cocaine is a white powder. It can be snorted up the nose or mixed with water and injected with a needle. Cocaine can also be made into small white rocks, called crack. Crack is smoked in a small glass pipe.

Cocaine speeds up your whole body. You may feel full of energy, happy, and excited. But then your mood can change. You can become angry, nervous, and afraid that someone's out to get you. You might do things that make no sense. After the "high" of the cocaine wears off, you can "crash" and feel tired and sad for days. You also get a strong craving to take the drug again to try to feel better.

No matter how cocaine is taken, it is dangerous. Some of the most common serious problems include heart attack and stroke. You are also at risk for HIV/AIDS and hepatitis, from sharing needles or having unsafe sex. Cocaine is more dangerous when combined with other drugs or alcohol.

It is easy to lose control over cocaine use and become addicted. Then, even if you get treatment, it can be hard to stay off the drug. People who stopped using cocaine can still feel strong cravings for the drug, sometimes even years later.

NIH: National Institute on Drug Abuse

  • Cocaine withdrawal (Medical Encyclopedia)
  • Substance use -- cocaine (Medical Encyclopedia)
  • Tips for Teens: The Truth about Cocaine (Substance Abuse and Mental Health Services Administration)

[Read More]

ICD-10 Footnotes

General Equivalence Map Definitions
The ICD-10 and ICD-9 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.

  • Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
  • No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
  • Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.