2024 ICD-10-CM Diagnosis Code T45.3X4

Poisoning by enzymes, undetermined

ICD-10-CM Code:
T45.3X4
ICD-10 Code for:
Poisoning by enzymes, undetermined
Is Billable?
Not Valid for Submission
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 primarily systemic and hematological agents, not elsewhere classified
        (T45)

T45.3X4 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of poisoning by enzymes, undetermined. The code is not specific and is NOT valid for the year 2024 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.

Specific Coding Applicable to Poisoning by enzymes, undetermined

Non-specific codes like T45.3X4 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10-CM codes with a higher level of specificity when coding for poisoning by enzymes, undetermined:

  • Use T45.3X4A for initial encounter - BILLABLE CODE

  • Use T45.3X4D for subsequent encounter - BILLABLE CODE

  • Use T45.3X4S for sequela - BILLABLE CODE

Clinical Information

  • Bromelains

    protein-digesting and milk-clotting enzymes found in pineapple fruit juice and stem tissue. enzymes from the two sources are distinguished as fruit bromelain and stem bromelain. this enzyme was formerly listed as ec 3.4.22.4.
  • Acatalasia

    a rare autosomal recessive disorder resulting from the absence of catalase activity. though usually asymptomatic, a syndrome of oral ulcerations and gangrene may be present.
  • Catalase

    an oxidoreductase that catalyzes the conversion of hydrogen peroxide to water and oxygen. it is present in many animal cells. a deficiency of this enzyme results in acatalasia.
  • Chymopapain

    a cysteine endopeptidase isolated from papaya latex. preferential cleavage at glutamic and aspartic acid residues. ec 3.4.22.6.
  • Chymases

    a family of neutral serine proteases with chymotrypsin-like activity. chymases are primarily found in the secretory granules of mast cells and are released during mast cell degranulation.
  • Chymotrypsin

    a serine endopeptidase secreted by the pancreas as its zymogen, chymotrypsinogen and carried in the pancreatic juice to the duodenum where it is activated by trypsin. it selectively cleaves aromatic amino acids on the carboxyl side.
  • Chymotrypsinogen

  • Coronavirus 3C Proteases

    3c proteases that occur in species of coronaviridae.
  • Penicillinase

    a beta-lactamase preferentially cleaving penicillins. (dorland, 28th ed) ec 3.5.2.-.
  • Pronase

    a proteolytic enzyme obtained from streptomyces griseus.
  • alpha 1-Antitrypsin

    plasma glycoprotein member of the serpin superfamily which inhibits trypsin; neutrophil elastase; and other proteolytic enzymes.
  • Aprotinin

    a single-chain polypeptide derived from bovine tissues consisting of 58 amino-acid residues. it is an inhibitor of proteolytic enzymes including chymotrypsin; kallikrein; plasmin; and trypsin. it is used in the treatment of hemorrhage associated with raised plasma concentrations of plasmin. it is also used to reduce blood loss and transfusion requirements in patients at high risk of major blood loss during and following open heart surgery with extracorporeal circulation. (reynolds jef(ed): martindale: the extra pharmacopoeia (electronic version). micromedex, inc, englewood, co, 1995)
  • Receptor, PAR-2

    a g-protein-coupled, proteinase-activated receptor that is expressed in a variety of tissues including endothelium; leukocytes; and the gastrointestinal tract. the receptor is activated by trypsin, which cleaves off the n-terminal peptide from the receptor. the new n-terminal peptide is a cryptic ligand for the receptor. the uncleaved receptor can also be activated by the n-terminal peptide present on the activated thrombin receptor and by small synthetic peptides that contain the unmasked n-terminal sequence.
  • Trypsin

    a serine endopeptidase that is formed from trypsinogen in the pancreas. it is converted into its active form by enteropeptidase in the small intestine. it catalyzes hydrolysis of the carboxyl group of either arginine or lysine. ec 3.4.21.4.
  • Trypsin Inhibitor, Bowman-Birk Soybean

    a low-molecular-weight protein (minimum molecular weight 8000) which has the ability to inhibit trypsin as well as chymotrypsin at independent binding sites. it is characterized by a high cystine content and the absence of glycine.
  • Trypsin Inhibitor, Kazal Pancreatic

    a secreted kazal motif-containing serine peptidase inhibitor that inhibits trypsin. it is a protein composed of 56 amino acid residues and is different in amino acid composition and physiological activity from the kunitz bovine pancreatic trypsin inhibitor (aprotinin). it protects against the trypsin-mediated premature activation of enzyme precursors in the pancreas. mutations in the spink1 gene are associated with chronic pancreatitis.
  • Trypsin Inhibitor, Kunitz Soybean

    a high-molecular-weight protein (approximately 22,500) containing 198 amino acid residues. it is a strong inhibitor of trypsin and human plasmin.
  • Trypsin Inhibitors

    serine proteinase inhibitors which inhibit trypsin. they may be endogenous or exogenous compounds.
  • Trypsinogen

    the inactive proenzyme of trypsin secreted by the pancreas, activated in the duodenum via cleavage by enteropeptidase. (stedman, 25th ed)

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 primarily systemic and hematological agents, not elsewhere classified (T45). Use the following options for the aplicable episode of care:

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

Table of Drugs and Chemicals

The 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
AlgluceraseT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
AlidaseT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
BrinaseT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
BromelainsT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
CatalaseT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
ChymarT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
Chymar
  »ophthalmic preparation
T45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
ChymopapainT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
ChymotrypsinT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
Chymotrypsin
  »ophthalmic preparation
T45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
CocarboxylaseT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
Deoxyribonuclease (pancreatic)T45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
DiffusinT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
EnzodaseT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
Enzyme NECT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
Enzyme NEC
  »depolymerizing
T45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
Enzyme NEC
  »fibrolytic
T45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
Enzyme NEC
  »gastric
T45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
Enzyme NEC
  »intestinal
T45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
Enzyme NEC
  »local action
T45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
Enzyme NEC
  »proteolytic
T45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
Enzyme NEC
  »thrombolytic
T45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
HyaluronidaseT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
HyazymeT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
PenicillinaseT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
PronaseT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
SerrapeptaseT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
StreptodornaseT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
SutilainsT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6
TrypsinT45.3X1T45.3X2T45.3X3T45.3X4T45.3X5T45.3X6

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.


[Learn More in MedlinePlus]

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.