2024 ICD-10-CM Diagnosis Code T46.4X4D

Poisoning by angiotensin-converting-enzyme inhibitors, undetermined, subsequent encounter

ICD-10-CM Code:
T46.4X4D
ICD-10 Code for:
Poisoning by angiotens-convert-enzyme inhibtr, undet, subs
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)

T46.4X4D is a billable diagnosis code used to specify a medical diagnosis of poisoning by angiotensin-converting-enzyme inhibitors, undetermined, 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.

T46.4X4D 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 angiotensin-converting-enzyme inhibitors undetermined. 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.

Clinical Classification

Clinical Information

  • Captopril

    a potent and specific inhibitor of peptidyl-dipeptidase a. it blocks the conversion of angiotensin i to angiotensin ii, a vasoconstrictor and important regulator of arterial blood pressure. captopril acts to suppress the renin-angiotensin system and inhibits pressure responses to exogenous angiotensin.
  • Cilazapril

    one of the angiotensin-converting enzyme inhibitors (ace inhibitors) used for hypertension. it is a prodrug that is hydrolyzed after absorption to its main metabolite cilazaprilat.
  • Enalapril

    an angiotensin-converting enzyme inhibitor that is used to treat hypertension and heart failure.
  • Enalaprilat

    the active metabolite of enalapril and one of the potent, intravenously administered, angiotensin-converting enzyme inhibitors. it is an effective agent for the treatment of essential hypertension and has beneficial hemodynamic effects in heart failure. the drug produces renal vasodilation with an increase in sodium excretion.
  • Fosinopril

    a phosphinic acid-containing angiotensin-converting enzyme inhibitor that is effective in the treatment of hypertension. it is a prodrug that is converted to its active metabolite fosinoprilat.
  • Lisinopril

    one of the angiotensin-converting enzyme inhibitors (ace inhibitors), orally active, that has been used in the treatment of hypertension and congestive heart failure.
  • Perindopril

    an angiotensin-converting enzyme inhibitor. it is used in patients with hypertension and heart failure.
  • Quinapril

    a tetrahydroisoquinoline derivative and angiotensin converting enzyme inhibitor that is used in the treatment of hypertension and heart failure.
  • Ramipril

    a long-acting angiotensin-converting enzyme inhibitor. it is a prodrug that is transformed in the liver to its active metabolite ramiprilat.

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)

T46.4X4D 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 T46.4X4D 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 T46.4X4 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
AlaceprilT46.4X1T46.4X2T46.4X3T46.4X4T46.4X5T46.4X6
BenazeprilT46.4X1T46.4X2T46.4X3T46.4X4T46.4X5T46.4X6
CaptoprilT46.4X1T46.4X2T46.4X3T46.4X4T46.4X5T46.4X6
CilazaprilT46.4X1T46.4X2T46.4X3T46.4X4T46.4X5T46.4X6
EnalaprilT46.4X1T46.4X2T46.4X3T46.4X4T46.4X5T46.4X6
EnalaprilatT46.4X1T46.4X2T46.4X3T46.4X4T46.4X5T46.4X6
FosinoprilT46.4X1T46.4X2T46.4X3T46.4X4T46.4X5T46.4X6
Fosinopril
  »sodium
T46.4X1T46.4X2T46.4X3T46.4X4T46.4X5T46.4X6
InhibitorT46.4X1T46.4X2T46.4X3T46.4X4T46.4X5T46.4X6
Inhibitor
  »angiotensin-converting enzyme
T46.4X1T46.4X2T46.4X3T46.4X4T46.4X5T46.4X6
Inhibitor
  »carbonic anhydrase
T46.4X1T46.4X2T46.4X3T46.4X4T46.4X5T46.4X6
Inhibitor
  »fibrinolysis
T46.4X1T46.4X2T46.4X3T46.4X4T46.4X5T46.4X6
Inhibitor
  »monoamine oxidase NEC
T46.4X1T46.4X2T46.4X3T46.4X4T46.4X5T46.4X6
Inhibitor
  »monoamine oxidase NEC
    »hydrazine
T46.4X1T46.4X2T46.4X3T46.4X4T46.4X5T46.4X6
Inhibitor
  »postsynaptic
T46.4X1T46.4X2T46.4X3T46.4X4T46.4X5T46.4X6
Inhibitor
  »prothrombin synthesis
T46.4X1T46.4X2T46.4X3T46.4X4T46.4X5T46.4X6
LisinoprilT46.4X1T46.4X2T46.4X3T46.4X4T46.4X5T46.4X6
PerindoprilT46.4X1T46.4X2T46.4X3T46.4X4T46.4X5T46.4X6
QuinaprilT46.4X1T46.4X2T46.4X3T46.4X4T46.4X5T46.4X6
RamiprilT46.4X1T46.4X2T46.4X3T46.4X4T46.4X5T46.4X6
SpiraprilT46.4X1T46.4X2T46.4X3T46.4X4T46.4X5T46.4X6
ZofenoprilT46.4X1T46.4X2T46.4X3T46.4X4T46.4X5T46.4X6

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.