2026 ICD-10-CM Diagnosis Code T40.492SPoisoning by other synthetic narcotics, intentional self-harm, sequela
T40.492S is a billable ICD-10-CM diagnosis code for poisoning by other synthetic narcotics, intentional self-harm, 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 2026 (October 1, 2025 through September 30, 2026) 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 Mental and substance use disorders; sequela; and Poisoning/toxic effect/adverse effects/underdosing, sequela.
Code Identity
Code Classification
Present on Admission (POA)Billing
T40.492S is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Acetaminophen and/or dextropropoxyphene overdose
- Buprenorphine overdose
- Buprenorphine poisoning
- Dextromoramide overdose
- Dextromoramide poisoning
- Dextropropoxyphene overdose
- Dextropropoxyphene poisoning
- Dipipanone overdose
- Dipipanone poisoning
- Intentional acetaminophen and/or dextropropoxyphene overdose
- Intentional acetaminophen and/or dextropropoxyphene poisoning
- Intentional buprenorphine overdose
- Intentional buprenorphine poisoning
- Intentional dextromoramide overdose
- Intentional dextromoramide poisoning
- Intentional dextropropoxyphene overdose
- Intentional dextropropoxyphene poisoning
- Intentional dipipanone overdose
- Intentional dipipanone poisoning
- Intentional levorphanol overdose
- Intentional levorphanol poisoning
- Intentional meperidine overdose
- Intentional meperidine poisoning
- Intentional nalbuphine overdose
- Intentional nalbuphine poisoning
- Intentional pentazocine overdose
- Intentional pentazocine poisoning
- Intentional phenazocine overdose
- Intentional phenazocine poisoning
- Intentional phenoperidine overdose
- Intentional phenoperidine poisoning
- Levorphanol overdose
- Levorphanol poisoning
- Meperidine overdose
- Morphinan opioid overdose
- Nalbuphine overdose
- Nalbuphine poisoning
- Pentazocine overdose
- Phenazocine overdose
- Phenazocine poisoning
- Phenoperidine overdose
- Phenoperidine poisoning
- Poisoning by meperidine
- Poisoning by pentazocine
- Suicide attempt by buprenorphine and naloxone overdose
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 narcotics and psychodysleptics [hallucinogens] (T40). 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 2026, published by CMS and the National Center for Health Statistics.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
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)
Table of Drugs and ChemicalsClinical
Substances in the Table of Drugs and Chemicals that reference this code family. Always confirm in the Tabular List before coding.
Code History & ChangesHistory
Replacement T40.492S replaces the following previously assigned code(s):
- T40.4X2S - Poisoning by oth synthetic narcotics, self-harm, sequela
Questions About T40.492SOverview
Is T40.492S a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report poisoning by other synthetic narcotics, intentional self-harm, sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character S in T40.492S mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the poisoning by other synthetic narcotics, intentional self-harm itself has resolved, not the original event.
What MS-DRG does T40.492S group to?
When poisoning by other synthetic narcotics, intentional self-harm, sequela is the principal diagnosis on an inpatient stay, it groups to MS-DRG 922, 923, with relative weights from 1.0177 to 1.7494 depending on complications. Higher weights mean higher Medicare reimbursement.
Is T40.492S exempt from POA reporting?
Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for poisoning by other synthetic narcotics, intentional self-harm, sequela on inpatient claims.
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.
