2024 ICD-10-CM Diagnosis Code T44.4X2S

Poisoning by predominantly alpha-adrenoreceptor agonists, intentional self-harm, sequela

ICD-10-CM Code:
T44.4X2S
ICD-10 Code for:
Poisn by predom alpha-adrenocpt agonists, self-harm, sequela
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Not chronic
Code Navigator:

Code Classification

  • Injury, poisoning and certain other consequences of external causes
    (S00–T88)
    • Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances
      (T36-T50)
      • Poisoning by, adverse effect of and underdosing of drugs primarily affecting the autonomic nervous system
        (T44)

T44.4X2S is a billable diagnosis code used to specify a medical diagnosis of poisoning by predominantly alpha-adrenoreceptor agonists, intentional self-harm, sequela. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

T44.4X2S is a sequela code, includes a 7th character and should be used for complications that arise as a direct result of a condition like poisoning by predominantly alpha-adrenoreceptor agonists intentional self-harm. According to ICD-10-CM Guidelines a "sequela" code should be used for chronic or residual conditions that are complications of an initial acute disease, illness or injury. The most common sequela is pain. Usually, two diagnosis codes are needed when reporting sequela. The first code describes the nature of the sequela while the second code describes the sequela or late effect.

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Alpha-adrenoceptor agonist overdose
  • Intentional metaraminol overdose
  • Intentional metaraminol poisoning
  • Intentional norepinephrine poisoning
  • Metaraminol overdose
  • Poisoning by metaraminol
  • Poisoning by metaraminol
  • Poisoning caused by norepinephrine
  • Vasopressor drug overdose

Clinical Classification

Clinical CategoryCCSR Category CodeInpatient Default CCSROutpatient Default CCSR
Mental and substance use disorders; sequelaMBD034Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Poisoning/toxic effect/adverse effects/underdosing, sequelaINJ075N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis.N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.

Clinical Information

  • Etilefrine

    a phenylephrine-related beta-1 adrenergic and alpha adrenergic agonist used as a cardiotonic and antihypotensive agent.
  • Metaraminol

    a sympathomimetic agent that acts predominantly at alpha-1 adrenergic receptors. it has been used primarily as a vasoconstrictor in the treatment of hypotension.
  • Methoxamine

    an alpha-1 adrenergic agonist that causes prolonged peripheral vasoconstriction.
  • Norepinephrine

    precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. norepinephrine is the principal transmitter of most postganglionic sympathetic fibers, and of the diffuse projection system in the brain that arises from the locus ceruleus. it is also found in plants and is used pharmacologically as a sympathomimetic.
  • Norepinephrine Plasma Membrane Transport Proteins

    sodium chloride-dependent neurotransmitter symporters located primarily on the plasma membrane of noradrenergic neurons. they remove norepinephrine from the extracellular space by high affinity reuptake into presynaptic terminals. the norepinephrine transporter regulates signal amplitude and duration at noradrenergic synapses and is the target of adrenergic uptake inhibitors.
  • Phenylethanolamine N-Methyltransferase

    a methyltransferase that catalyzes the reaction of s-adenosyl-l-methionine and phenylethanolamine to yield s-adenosyl-l-homocysteine and n-methylphenylethanolamine. it can act on various phenylethanolamines and converts norepinephrine into epinephrine. (from enzyme nomenclature, 1992) ec 2.1.1.28.
  • Receptors, Adrenergic

    cell-surface proteins that bind epinephrine and/or norepinephrine with high affinity and trigger intracellular changes. the two major classes of adrenergic receptors, alpha and beta, were originally discriminated based on their cellular actions but now are distinguished by their relative affinity for characteristic synthetic ligands. adrenergic receptors may also be classified according to the subtypes of g-proteins with which they bind; this scheme does not respect the alpha-beta distinction.
  • Phenylephrine

    an alpha-1 adrenergic agonist used as a mydriatic, nasal decongestant, and cardiotonic agent.

Coding Guidelines

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 drugs primarily affecting the autonomic nervous system (T44). Use the following options for the aplicable episode of care:

  • A - initial encounter
  • D - subsequent encounter
  • S - sequela

Present on Admission (POA)

T44.4X2S 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. Review other POA exempt codes here.

CMS POA Indicator Options and Definitions

POA IndicatorReason 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

Convert T44.4X2S to ICD-9-CM

  • ICD-9-CM Code: 909.0 - Late eff drug poisoning
    Combination Flag - Multiple codes are needed to describe the source diagnosis code. Correct coding should be done based on contextual judgment.
  • ICD-9-CM Code: E959 - Late eff of self-injury
    Combination Flag - Multiple codes are needed to describe the source diagnosis code. Correct coding should be done based on contextual judgment.

Table of Drugs and Chemicals

The parent code T44.4X2 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
AgonistT44.4X1T44.4X2T44.4X3T44.4X4T44.4X5T44.4X6
Agonist
  »predominantly
T44.4X1T44.4X2T44.4X3T44.4X4T44.4X5T44.4X6
Agonist
  »predominantly
    »alpha-adrenoreceptor
T44.4X1T44.4X2T44.4X3T44.4X4T44.4X5T44.4X6
Agonist
  »predominantly
    »beta-adrenoreceptor
T44.4X1T44.4X2T44.4X3T44.4X4T44.4X5T44.4X6
AplonidineT44.4X1T44.4X2T44.4X3T44.4X4T44.4X5T44.4X6
Apraclonidine (hydrochloride)T44.4X1T44.4X2T44.4X3T44.4X4T44.4X5T44.4X6
CyclopentamineT44.4X1T44.4X2T44.4X3T44.4X4T44.4X5T44.4X6
EtilefrineT44.4X1T44.4X2T44.4X3T44.4X4T44.4X5T44.4X6
GepefrineT44.4X1T44.4X2T44.4X3T44.4X4T44.4X5T44.4X6
LevarterenolT44.4X1T44.4X2T44.4X3T44.4X4T44.4X5T44.4X6
MetaraminolT44.4X1T44.4X2T44.4X3T44.4X4T44.4X5T44.4X6
MethoxamineT44.4X1T44.4X2T44.4X3T44.4X4T44.4X5T44.4X6
NoradrenalineT44.4X1T44.4X2T44.4X3T44.4X4T44.4X5T44.4X6
NorepinephrineT44.4X1T44.4X2T44.4X3T44.4X4T44.4X5T44.4X6
NorfenefrineT44.4X1T44.4X2T44.4X3T44.4X4T44.4X5T44.4X6
OxedrineT44.4X1T44.4X2T44.4X3T44.4X4T44.4X5T44.4X6
ParedrineT44.4X1T44.4X2T44.4X3T44.4X4T44.4X5T44.4X6
PhenylephrineT44.4X1T44.4X2T44.4X3T44.4X4T44.4X5T44.4X6
PrivineT44.4X1T44.4X2T44.4X3T44.4X4T44.4X5T44.4X6

Patient Education


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:

  • Prescription or over-the-counter medicines taken in doses that are too high
  • Overdoses of illegal drugs
  • Carbon monoxide from gas appliances
  • Household products, such as laundry powder or furniture polish
  • Pesticides
  • Indoor or outdoor plants
  • Metals such as lead and mercury

The effects of poisoning range from short-term illness to brain damage, coma, and death. To prevent poisoning it is important to use and store products exactly as their labels say. Keep dangerous products where children can't get to them. Treatment for poisoning depends on the type of poison. If you suspect someone has been poisoned, call your local poison control center at 1-800-222-1222 right away.


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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 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.

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.