2024 ICD-10-CM Diagnosis Code T45.7X2D
Poisoning by anticoagulant antagonists, vitamin K and other coagulants, intentional self-harm, subsequent encounter
- ICD-10-CM Code:
- T45.7X2D
- ICD-10 Code for:
- Poisn by anticoag antag, vit K and oth coag, slf-hrm, subs
- Is Billable?
- Yes - Valid for Submission
- Chronic Condition Indicator: [1]
- Not chronic
- Code Navigator:
- Code Information
- Approximate Synonyms
- Clinical Classification
- Clinical Information
- Coding Guidelines
- Tabular List of Diseases and Injuries
- Diagnostic Related Groups Mapping
- Present on Admission (POA)
- Convert to ICD-9 Code
- Table of Drugs and Chemicals
- Patient Education
- Other Codes Used Similar Conditions
- Code History
T45.7X2D is a billable diagnosis code used to specify a medical diagnosis of poisoning by anticoagulant antagonists, vitamin k and other coagulants, intentional self-harm, subsequent encounter. 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.
T45.7X2D is a subsequent encounter code, includes a 7th character and should be used after the patient has completed active treatment for a condition like poisoning by anticoagulant antagonists vitamin k and other coagulants intentional self-harm. According to ICD-10-CM Guidelines a "subsequent encounter" occurs when the patient is receiving routine care for the condition during the healing or recovery phase of treatment. Subsequent diagnosis codes are appropriate during the recovery phase, no matter how many times the patient has seen the provider for this condition. If the provider needs to adjust the patient's care plan due to a setback or other complication, the encounter becomes active again.
Approximate Synonyms
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Antidote overdose
- Intentional protamine overdose
- Intentional protamine poisoning
- Intentional vitamin K and/or vitamin K derivative overdose
- Intentional vitamin K poisoning
- Poisoning by vitamin K
- Poisoning by vitamin K
- Poisoning caused by protamine
- Poisoning caused by protamine
- Protamine overdose
- Vitamin K and/or vitamin K derivative overdose
Clinical Classification
Clinical Category | CCSR Category Code | Inpatient Default CCSR | Outpatient Default CCSR |
---|---|---|---|
Poisoning by drugs, subsequent encounter | INJ059 | N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis. | N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis. |
Suicide attempt/intentional self-harm; subsequent encounter | MBD027 | Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis. | Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis. |
Clinical Information
Ethamsylate
benzenesulfonate derivative used as a systemic hemostatic.Hypoprothrombinemias
absence or reduced levels of prothrombin in the blood.Prothrombin
a plasma protein that is the inactive precursor of thrombin. it is converted to thrombin by a prothrombin activator complex consisting of factor xa, factor v, phospholipid, and calcium ions. deficiency of prothrombin leads to hypoprothrombinemia.Prothrombin Time
clotting time of plasma recalcified in the presence of excess tissue thromboplastin. factors measured are fibrinogen; prothrombin; factor v; factor vii; and factor x. it is used for monitoring anticoagulant therapy with coumarins.Thromboplastin
constituent composed of protein and phospholipid that is widely distributed in many tissues. it serves as a cofactor with factor viia to activate factor x in the extrinsic pathway of blood coagulation.Anticoagulants
agents that prevent blood clotting.Antithrombins
endogenous factors and drugs that directly inhibit the action of thrombin, usually by blocking its enzymatic activity. they are distinguished from indirect thrombin inhibitors, such as heparin, which act by enhancing the inhibitory effects of antithrombins.Carboxypeptidase B2
a carboxypeptidase that removes c-terminal lysine or arginine from peptides and proteins. carboxypeptidase b2 (cpb2) is released into the circulation as a proenzyme which is activated by the thrombin-thrombomodulin complex. activated cpb2 is involved in modulating a variety of processes by cleaving and inactivating various circulating proteins and peptides that are its substrates including fibrin; kinins; and anaphylatoxins.Factor VIIIa
activated form of factor viii. the b-domain of factor viii is proteolytically cleaved by thrombin to form factor viiia. factor viiia exists as a non-covalent dimer in a metal-linked (probably calcium) complex and functions as a cofactor in the enzymatic activation of factor x by factor ixa. factor viiia is similar in structure and generation to factor va.Receptors, Thrombin
a family of proteinase-activated receptors that are specific for thrombin. they are found primarily on platelets and on endothelial cells. activation of thrombin receptors occurs through the proteolytic action of thrombin, which cleaves the n-terminal peptide from the receptor to reveal a new n-terminal peptide that is a cryptic ligand for the receptor. the receptors signal through heterotrimeric gtp-binding proteins. small synthetic peptides that contain the unmasked n-terminal peptide sequence can also activate the receptor in the absence of proteolytic activity.Thrombin
an enzyme formed from prothrombin that converts fibrinogen to fibrin.Thrombin Time
clotting time of plasma mixed with a thrombin solution. it is a measure of the conversion of fibrinogen to fibrin, which is prolonged by afibrinogenemia, abnormal fibrinogen, or the presence of inhibitory substances, e.g., fibrin-fibrinogen degradation products, or heparin. batroxobin, a thrombin-like enzyme unaffected by the presence of heparin, may be used in place of thrombin.Factor VIII
factor viii of blood coagulation. antihemophilic factor that is part of the factor viii/von willebrand factor complex. factor viii is produced in the liver and acts in the intrinsic pathway of blood coagulation. it serves as a cofactor in factor x activation and this action is markedly enhanced by small amounts of thrombin.Factor XI
stable blood coagulation factor involved in the intrinsic pathway. the activated form xia activates factor ix to ixa. deficiency of factor xi is often called hemophilia c.Partial Thromboplastin Time
the time required for the appearance of fibrin strands following the mixing of plasma with phospholipid platelet substitute (e.g., crude cephalins, soybean phosphatides). it is a test of the intrinsic pathway (factors viii, ix, xi, and xii) and the common pathway (fibrinogen, prothrombin, factors v and x) of blood coagulation. it is used as a screening test and to monitor heparin therapy.
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
Present on Admission (POA)
T45.7X2D 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 Indicator | Reason for Code | CMS will pay the CC/MCC DRG? |
---|---|---|
Y | Diagnosis was present at time of inpatient admission. | YES |
N | Diagnosis was not present at time of inpatient admission. | NO |
U | Documentation insufficient to determine if the condition was present at the time of inpatient admission. | NO |
W | Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission. | YES |
1 | Unreported/Not used - Exempt from POA reporting. | NO |
Convert T45.7X2D to ICD-9-CM
- ICD-9-CM Code: V58.89 - Other specfied aftercare
Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.
Table of Drugs and Chemicals
The parent code T45.7X2 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.
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.
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.