2026 ICD-10-CM Diagnosis Code T42.0X3APoisoning by hydantoin derivatives, assault, initial encounter

ICD-10-CM Codes›S00–T88›T36-T50›T42

ICD-10-CM T42.0X3A
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

T42.0X3A is a billable ICD-10-CM diagnosis code for poisoning by hydantoin derivatives, assault, initial encounter. The 7th character A marks it as an initial encounter code, used while the patient is receiving active treatment. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 917 through 918. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under External cause codes: intent of injury, assault; External cause codes: poisoning by drug; and Poisoning by drugs, initial encounter.

Code Identity

ICD-10-CM Code
T42.0X3A
Billable Status
Yes — Valid for Submission
Code Describes
Poisoning by hydantoin derivatives, assault, initial encounter
Short Description
Poisoning by hydantoin derivatives, assault, init encntr
Parent Code
T42.0X3
Poisoning by hydantoin derivatives, assault

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionT36-T50Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances
CategoryT42Poisoning by, adverse effect of and underdosing of antiepileptic, sedative- hypnotic and antiparkinsonism drugs
This CodeT42.0X3APoisoning by hydantoin derivatives, assault, initial encounter

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 antiepileptic, sedative- hypnotic and antiparkinsonism drugs (T42). 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.

CCSR EXT022
External cause codes: intent of injury, assault
Default principal diagnosis: inpatient No · outpatient No
CCSR EXT014
External cause codes: poisoning by drug
Default principal diagnosis: inpatient No · outpatient No
CCSR INJ022
Poisoning by drugs, initial encounter
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Mephenytoin

    an anticonvulsant effective in tonic-clonic epilepsy (epilepsy, tonic-clonic). it may cause blood dyscrasias.

  • Phenytoin

    an anticonvulsant that is used to treat a wide variety of seizures. it is also an anti-arrhythmic and a muscle relaxant. the mechanism of therapeutic action is not clear, although several cellular actions have been described including effects on ion channels, active transport, and general membrane stabilization. the mechanism of its muscle relaxant effect appears to involve a reduction in the sensitivity of muscle spindles to stretch. phenytoin has been proposed for several other therapeutic uses, but its use has been limited by its many adverse effects and interactions with other drugs.

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.

SubstanceAccidentalSelf-harmAssaultUndeter­minedAdverse
Effect		Under­dosing
AlbutoinT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
DilantinT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
DiphenylhydantoinT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
EpanutinT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
EthotoinT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
Hydantoin derivative NECT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
MephenytoinT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
Mephenytoin::with phenobarbitalT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
MetetoinT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
MethetoinT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
MethoinT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
PhenantoinT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
PhenytoinT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6
Phenytoin::with PhenobarbitalT42.0X1T42.0X2T42.0X3T42.0X4T42.0X5T42.0X6

Patient EducationClinical

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:

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert T42.0X3A to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
966.1 Poison-hydantoin derivat
ApproximateCombination The match is approximate, and more than one code can be needed to describe the source diagnosis. Confirm with contextual judgment.
ICD-9-CM
E962.0 Assault-pois w medic agt
ApproximateCombination The match is approximate, and more than one code can be needed to describe the source diagnosis. Confirm with contextual judgment.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About T42.0X3AOverview

Is T42.0X3A (Poisoning by hydantoin derivatives, assault) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report poisoning by hydantoin derivatives, assault, initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character A in T42.0X3A mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for poisoning by hydantoin derivatives, assault, such as an emergency visit or first evaluation.

What MS-DRG does T42.0X3A group to?

When poisoning by hydantoin derivatives, assault, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 917, 918, with relative weights from 0.8571 to 1.5684 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of T42.0X3A?

Under the General Equivalence Mappings, poisoning by hydantoin derivatives, assault, initial encounter converts to ICD-9-CM 966.1 (poison-hydantoin derivat) and E962.0 (assault-pois w medic agt). The mapping is approximate, so confirm the match fits the documentation.

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.