2026 ICD-10-CM Diagnosis Code T45.4X4SPoisoning by iron and its compounds, undetermined, sequela
T45.4X4S is a billable ICD-10-CM diagnosis code for poisoning by iron and its compounds, undetermined, 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. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Poisoning/toxic effect/adverse effects/underdosing, sequela.
Code Identity
Code Classification
Present on Admission (POA)Billing
T45.4X4S is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.
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.
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.
| Substance | Accidental | Self-harm | Assault | Undetermined | Adverse Effect | Underdosing |
|---|---|---|---|---|---|---|
| Dextriferron | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Ferric [See Also: Iron] | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Ferric [See Also: Iron]::chloride | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Ferric [See Also: Iron]::citrate | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Ferric [See Also: Iron]::hydroxide | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Ferric [See Also: Iron]::hydroxide::colloidal | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Ferric [See Also: Iron]::hydroxide::polymaltose | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Ferric [See Also: Iron]::pyrophosphate | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Ferritin | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Ferrocholinate | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Ferrodextrane | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Ferropolimaler | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Ferrous [See Also: Iron] | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Ferrous [See Also: Iron]::phosphate | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Ferrous [See Also: Iron]::salt | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Ferrous [See Also: Iron]::salt::with folic acid | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Ferrous fumerate, gluconate, lactate, salt NEC, sulfate (medicinal) | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Iron (compounds) (medicinal) NEC | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Iron (compounds) (medicinal) NEC::ammonium | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Iron (compounds) (medicinal) NEC::dextran injection | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Iron (compounds) (medicinal) NEC::nonmedicinal | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Iron (compounds) (medicinal) NEC::salts | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Iron (compounds) (medicinal) NEC::sorbitex | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Iron (compounds) (medicinal) NEC::sorbitol citric acid complex | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Isomaltose, ferric complex | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Jectofer | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
| Polyferose | T45.4X1 | T45.4X2 | T45.4X3 | T45.4X4 | T45.4X5 | T45.4X6 |
Patient EducationClinical
Iron
Iron is a mineral that our bodies need for growth and development. Your body uses iron to make hemoglobin, a protein in red blood cells. Hemoglobin carries oxygen from the lungs to all parts of the body. Iron is also important for healthy muscles, bone marrow, and organ function. Your body also needs iron to make some hormones.
The full article covers:
- What is iron?
- How do you get iron?
- What causes low iron?
- What happens if you don't get enough iron?
- What happens if you get too much iron?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert T45.4X4S to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About T45.4X4SOverview
Is T45.4X4S (Poisoning by iron and its compounds, undetermined) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report poisoning by iron and its compounds, undetermined, sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character S in T45.4X4S 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, undetermined itself has resolved, not the original event.
What MS-DRG does T45.4X4S group to?
When poisoning by iron and its compounds, undetermined, 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 T45.4X4S 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, undetermined, sequela on inpatient claims.
What is the ICD-9 equivalent of T45.4X4S?
Under the General Equivalence Mappings, poisoning by iron and its compounds, undetermined, sequela converts to ICD-9-CM 909.0 (late eff drug poisoning) and E989 (late eff inj-undet circ). 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.
