2024 ICD-10-CM Diagnosis Code T40.725A
Adverse effect of synthetic cannabinoids, initial encounter
- ICD-10-CM Code:
- T40.725A
- ICD-10 Code for:
- Adverse effect of synthetic cannabinoids, initial encounter
- Is Billable?
- Yes - Valid for Submission
- Chronic Condition Indicator: [1]
- Not chronic
- Code Navigator:
T40.725A is a billable diagnosis code used to specify a medical diagnosis of adverse effect of synthetic cannabinoids, initial 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.
This code describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.
T40.725A is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like adverse effect of synthetic cannabinoids. According to ICD-10-CM Guidelines an "initial encounter" doesn't necessarily means "initial visit". The 7th character should be used when the patient is undergoing active treatment regardless if new or different providers saw the patient over the course of a treatment. The appropriate 7th character codes should also be used even if the patient delayed seeking treatment for a condition.
Clinical Classification
| Clinical Category | CCSR Category Code | Inpatient Default CCSR | Outpatient Default CCSR |
|---|---|---|---|
| Adverse effects of drugs and medicaments, initial encounter | INJ028 | X - Not applicable. | Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis. |
| Cannabis-related disorders | MBD019 | X - Not applicable. | N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis. |
Coding Guidelines
When coding an adverse effect of a drug that has been correctly prescribed and properly administered, assign the appropriate code for the nature of the adverse effect followed by the appropriate code for the adverse effect of the drug.
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
Code Edits
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM 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.
Replacement Code
T40725A replaces the following previously assigned ICD-10-CM code(s):
- T40.7X5A - Adverse effect of cannabis (derivatives), initial encounter
Table of Drugs and Chemicals
The parent code T40.725 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 |
|---|---|---|---|---|---|---|
| Cannabinoids, synthetic | T40.721 | T40.722 | T40.723 | T40.724 | T40.725 | T40.726 |
| Synthetic cannabinoids | T40.721 | T40.722 | T40.723 | T40.724 | T40.725 | T40.726 |
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 - Code Added, effective from 10/1/2021 through 9/30/2022
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.