2024 ICD-10-CM Diagnosis Code T46.2X4S

Poisoning by other antidysrhythmic drugs, undetermined, sequela

ICD-10-CM Code:
T46.2X4S
ICD-10 Code for:
Poisoning by oth antidysrhy drugs, undetermined, 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 agents primarily affecting the cardiovascular system
        (T46)

T46.2X4S is a billable diagnosis code used to specify a medical diagnosis of poisoning by other antidysrhythmic drugs, undetermined, 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.

T46.2X4S 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 other antidysrhythmic drugs undetermined. 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.

Clinical Classification

Clinical Information

  • Ajmaline

    an alkaloid found in the root of rauwolfia serpentina, among other plant sources. it is a class 1-a antiarrhythmic agent that apparently acts by changing the shape and threshold of cardiac action potentials.
  • Amiodarone

    an antianginal and class iii antiarrhythmic drug. it increases the duration of ventricular and atrial muscle action by inhibiting potassium channels and voltage-gated sodium channels. there is a resulting decrease in heart rate and in vascular resistance.
  • Aprindine

    a class ib anti-arrhythmia agent used to manage ventricular and supraventricular arrhythmias.
  • Bunaftine

    n-butyl-n-(2-(diethylamino)ethyl)-1-naphthamide. a proposed antiarrhythmic that prolongs myocardial refractory period and stabilizes cell membranes.
  • Disopyramide

    a class i anti-arrhythmic agent (one that interferes directly with the depolarization of the cardiac membrane and thus serves as a membrane-stabilizing agent) with a depressant action on the heart similar to that of guanidine. it also possesses some anticholinergic and local anesthetic properties.
  • Encainide

    one of the anti-arrhythmia agents, it blocks voltage-gated sodium channels and slows conduction within the his-purkinje system and myocardium.
  • Flecainide

    a potent anti-arrhythmia agent, effective in a wide range of ventricular and atrial arrhythmias and tachycardias.
  • Lorajmine

    a monochloroacetyl derivative of ajmaline. it is a class ia antiarrhythmic agent that is rapidly hydrolyzed to ajmaline by plasma and tissue esterases.
  • Mexiletine

    antiarrhythmic agent pharmacologically similar to lidocaine. it may have some anticonvulsant properties.
  • Procainamide

    a class ia antiarrhythmic drug that is structurally-related to procaine.
  • Propafenone

    an antiarrhythmia agent that is particularly effective in ventricular arrhythmias. it also has weak beta-blocking activity.
  • Quinidine

    an optical isomer of quinine, extracted from the bark of the chinchona tree and similar plant species. this alkaloid dampens the excitability of cardiac and skeletal muscles by blocking sodium and potassium currents across cellular membranes. it prolongs cellular action potentials, and decreases automaticity. quinidine also blocks muscarinic and alpha-adrenergic neurotransmission.
  • Tocainide

    an antiarrhythmic agent which exerts a potential- and frequency-dependent block of sodium channels.

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 agents primarily affecting the cardiovascular system (T46). Use the following options for the aplicable episode of care:

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

Present on Admission (POA)

T46.2X4S 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 T46.2X4S 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: E989 - Late eff inj-undet circ
    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 T46.2X4 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
Adenosine (phosphate)T46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
AjmalineT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
AmiodaroneT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
Antidysrhythmic NECT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
AprindineT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
Bretylium tosilateT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
BunaftineT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
CardiacT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
Cardiac
  »depressants
T46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
Cardiac
  »rhythm regulator
T46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
Cardiac
  »rhythm regulator
    »specified NEC
T46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
Chinidin (e)T46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
CibenzolineT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
DisopyramideT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
EncainideT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
FlecainideT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
HydroquinidineT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
LorajmineT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
LorcainideT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
MexiletineT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
Pilsicainide (hydrochloride)T46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
Prajmalium bitartrateT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
ProcainamideT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
Pronestyl (hydrochloride)T46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
PropafenoneT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
QuinagluteT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
QuinidineT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6
TocainideT46.2X1T46.2X2T46.2X3T46.2X4T46.2X5T46.2X6

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.