2026 ICD-10-CM Diagnosis Code T42.5X1APoisoning by mixed antiepileptics, accidental (unintentional), initial encounter
T42.5X1A is a billable ICD-10-CM diagnosis code for poisoning by mixed antiepileptics, accidental (unintentional), 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, accidental/unintentional; External cause codes: poisoning by drug; and Poisoning by drugs, initial encounter.
Code Identity
Code Classification
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.
Patient EducationClinical
Medication Errors
Medicines treat infectious diseases, prevent problems from chronic diseases, and ease pain. But medicines can also cause harmful reactions if not used correctly. Errors can happen in the hospital, at the health care provider's office, at the pharmacy, or at home. You can help prevent errors by:
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert T42.5X1A to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About T42.5X1AOverview
Is T42.5X1A a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report poisoning by mixed antiepileptics, accidental (unintentional), initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character A in T42.5X1A mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for poisoning by mixed antiepileptics, accidental (unintentional), such as an emergency visit or first evaluation.
What MS-DRG does T42.5X1A group to?
When poisoning by mixed antiepileptics, accidental (unintentional), 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 T42.5X1A?
Under the General Equivalence Mappings, poisoning by mixed antiepileptics, accidental (unintentional), initial encounter converts to ICD-9-CM 966.3 (pois-anticonvul NEC/NOS) and E855.8 (acc poison-cns drug NEC). 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.
