2026 ICD-10-CM Diagnosis Code T45.4X2SPoisoning by iron and its compounds, intentional self-harm, sequela

ICD-10-CM Codes›S00–T88›T36-T50›T45

ICD-10-CM T45.4X2S
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

T45.4X2S is a billable ICD-10-CM diagnosis code for poisoning by iron and its compounds, intentional self-harm, sequela. The 7th character S marks it as a sequela code, which reports a problem that remains after the original condition has resolved. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 922 through 923. The code is exempt from POA reporting. Coders also document this condition as ferrous sulfate overdose. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Mental and substance use disorders; sequela; and Poisoning/toxic effect/adverse effects/underdosing, sequela.

Code Identity

ICD-10-CM Code
T45.4X2S
Billable Status
Yes — Valid for Submission
Code Describes
Poisoning by iron and its compounds, intentional self-harm, sequela
Short Description
Poisoning by iron and its compounds, self-harm, sequela
Parent Code
T45.4X2
Poisoning by iron and its compounds, intentional self-harm

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
CategoryT45Poisoning by, adverse effect of and underdosing of primarily systemic and hematological agents, not elsewhere classified
This CodeT45.4X2SPoisoning by iron and its compounds, intentional self-harm, sequela

Present on Admission (POA)Billing

T45.4X2S is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Ferrous sulfate overdose
  • Intentional ferric iron compound poisoning
  • Intentional ferrous sulfate overdose
  • Intentional ferrous sulfate poisoning
  • Iron and/or iron compound overdose
  • Poisoning by ferrous salt
  • Poisoning by ferrous sulfate
  • Poisoning caused by ferric iron compound

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 primarily systemic and hematological agents, not elsewhere classified (T45). 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 MBD034
Mental and substance use disorders; sequela
Default principal diagnosis: inpatient Yes · outpatient Yes
CCSR INJ075
Poisoning/toxic effect/adverse effects/underdosing, sequela
Default principal diagnosis: inpatient No · outpatient No

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
DextriferronT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
Ferric [See Also: Iron]T45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
Ferric [See Also: Iron]::chlorideT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
Ferric [See Also: Iron]::citrateT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
Ferric [See Also: Iron]::hydroxideT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
Ferric [See Also: Iron]::hydroxide::colloidalT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
Ferric [See Also: Iron]::hydroxide::polymaltoseT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
Ferric [See Also: Iron]::pyrophosphateT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
FerritinT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
FerrocholinateT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
FerrodextraneT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
FerropolimalerT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
Ferrous [See Also: Iron]T45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
Ferrous [See Also: Iron]::phosphateT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
Ferrous [See Also: Iron]::saltT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
Ferrous [See Also: Iron]::salt::with folic acidT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
Ferrous fumerate, gluconate, lactate, salt NEC, sulfate (medicinal)T45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
Iron (compounds) (medicinal) NECT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
Iron (compounds) (medicinal) NEC::ammoniumT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
Iron (compounds) (medicinal) NEC::dextran injectionT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
Iron (compounds) (medicinal) NEC::nonmedicinalT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
Iron (compounds) (medicinal) NEC::saltsT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
Iron (compounds) (medicinal) NEC::sorbitexT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
Iron (compounds) (medicinal) NEC::sorbitol citric acid complexT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
Isomaltose, ferric complexT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
JectoferT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6
PolyferoseT45.4X1T45.4X2T45.4X3T45.4X4T45.4X5T45.4X6

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 T45.4X2S to ICD-9-CMHistory

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

ICD-9-CM
909.0 Late eff drug poisoning
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
E959 Late eff of self-injury
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 T45.4X2SOverview

Is T45.4X2S (Poisoning by iron and its compounds, intentional self-harm) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report poisoning by iron and its compounds, intentional self-harm, sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character S in T45.4X2S mean?

The final character S makes this a sequela code: it reports a lingering problem that remains after the poisoning by iron and its compounds, intentional self-harm itself has resolved, not the original event.

What MS-DRG does T45.4X2S group to?

When poisoning by iron and its compounds, intentional self-harm, sequela is the principal diagnosis on an inpatient stay, it groups to MS-DRG 922, 923, with relative weights from 1.0177 to 1.7494 depending on complications. Higher weights mean higher Medicare reimbursement.

Is T45.4X2S exempt from POA reporting?

Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for poisoning by iron and its compounds, intentional self-harm, sequela on inpatient claims.

What is the ICD-9 equivalent of T45.4X2S?

Under the General Equivalence Mappings, poisoning by iron and its compounds, intentional self-harm, sequela converts to ICD-9-CM 909.0 (late eff drug poisoning) and E959 (late eff of self-injury). 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.