2024 ICD-10-CM Diagnosis Code T46.5X4S

Poisoning by other antihypertensive drugs, undetermined, sequela

ICD-10-CM Code:
T46.5X4S
ICD-10 Code for:
Poisoning by oth antihypertn 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)

T46.5X4S is a billable diagnosis code used to specify a medical diagnosis of poisoning by other antihypertensive 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.

T46.5X4S 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 antihypertensive 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

  • Bethanidine

    a guanidinium antihypertensive agent that acts by blocking adrenergic transmission. the precise mode of action is not clear.
  • Clonidine

    an imidazoline sympatholytic agent that stimulates alpha-2 adrenergic receptors and central imidazoline receptors. it is commonly used in the management of hypertension.
  • Diazoxide

    a benzothiadiazine derivative that is a peripheral vasodilator used for hypertensive emergencies. it lacks diuretic effect, apparently because it lacks a sulfonamide group.
  • Dihydralazine

    1,4-dihydrazinophthalazine. an antihypertensive agent with actions and uses similar to those of hydralazine. (from martindale, the extra pharmacopoeia, 30th ed, p354)
  • Dihydroergotamine

    a 9,10alpha-dihydro derivative of ergotamine. it is used as a vasoconstrictor, specifically for the therapy of migraine disorders.
  • Ergotamine

    a vasoconstrictor found in ergot of central europe. it is a serotonin agonist that has been used as an oxytocic agent and in the treatment of migraine disorders.
  • Ergotamines

    a series of structurally-related alkaloids containing the ergotaman backbone structure.
  • Guanabenz

    an alpha-2 selective adrenergic agonist used as an antihypertensive agent.
  • Guanethidine

    an antihypertensive agent that acts by inhibiting selectively transmission in post-ganglionic adrenergic nerves. it is believed to act mainly by preventing the release of norepinephrine at nerve endings and causes depletion of norepinephrine in peripheral sympathetic nerve terminals as well as in tissues.
  • Guanfacine

    a centrally acting antihypertensive agent with specificity towards adrenergic alpha-2 receptors.
  • Hydralazine

    a direct-acting vasodilator that is used as an antihypertensive agent.
  • Indapamide

    a benzamide-sulfonamide-indole derived diuretic that functions by inhibiting sodium chloride symporters.
  • Carbidopa

    an inhibitor of dopa decarboxylase that prevents conversion of levodopa to dopamine. it is used in parkinson disease to reduce peripheral adverse effects of levodopa. it has no anti-parkinson activity by itself.
  • Deoxyepinephrine

    sympathomimetic, vasoconstrictor agent.
  • Methyldopa

    an alpha-2 adrenergic agonist that has both central and peripheral nervous system effects. its primary clinical use is as an antihypertensive agent.
  • Methysergide

    an ergot derivative that is a congener of lysergic acid diethylamide. it antagonizes the effects of serotonin in blood vessels and gastrointestinal smooth muscle, but has few of the properties of other ergot alkaloids. methysergide is used prophylactically in migraine and other vascular headaches and to antagonize serotonin in the carcinoid syndrome.
  • Nitroprusside

    a powerful vasodilator used in emergencies to lower blood pressure or to improve cardiac function. it is also an indicator for free sulfhydryl groups in proteins.
  • Pargyline

    a monoamine oxidase inhibitor with antihypertensive properties.
  • Pinacidil

    a guanidine that opens potassium channels producing direct peripheral vasodilatation of the arterioles. it reduces blood pressure and peripheral resistance and produces fluid retention. (martindale the extra pharmacopoeia, 31st ed)
  • Saralasin

    an octapeptide analog of angiotensin ii (bovine) with amino acids 1 and 8 replaced with sarcosine and alanine, respectively. it is a highly specific competitive inhibitor of angiotensin ii that is used in the diagnosis of hypertension.
  • Teprotide

    a synthetic nonapeptide (pyr-trp-pro-arg-pro-gln-ile-pro-pro) which is identical to the peptide from the venom of the snake, bothrops jararaca. it inhibits kininase ii and angiotensin i and has been proposed as an antihypertensive agent.
  • Todralazine

    an antihypertensive agent with both central and peripheral action; it has some central nervous system depressant effects.
  • Veratrine

    a voltage-gated sodium channel activator.

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)

T46.5X4S 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 T46.5X4S 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 T46.5X4 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
AldometT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
AlkavervirT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
AlseroxylonT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
AmiquinsinT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
Antihypertensive drug NECT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
ApresolineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
Benzapril hydrochlorideT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
BetanidineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
BethanidineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
BudralazineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
CadralazineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
ClonidineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
Cryptenamine (tannates)T46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
DebrisoquineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
DeserpidineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
DiazoxideT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
DihydralazineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
DihydrazineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
DihydroergotamineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
EndralazineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
ErgotamineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
GuanabenzT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
GuanaclineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
GuanadrelT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
GuanethidineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
GuanfacineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
GuanochlorT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
GuanoclorT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
GuanoctineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
GuanoxabenzT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
GuanoxanT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
HarmonylT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
HydralazineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
Hypotensive NECT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
IndapamideT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
LacidipineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
MethoserpidineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
MethyldopaT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
MethyldopateT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
MethysergideT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
MetirosineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
ModerilT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
NitroprussideT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
PargylineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
PinacidilT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
Protoveratrine (s) (A) (B)T46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
RaudixinT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
RautensinT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
RautinaT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
RautotalT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
RauwiloidT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
RauwoldinT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
Rauwolfia (alkaloids)T46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
RescinnamineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
Reserpin (e)T46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
SandrilT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
SaralasinT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
SerpasilT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
SingoserpT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
SyrosingopineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
TeprotideT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
TodralazineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
TolonidineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
UrapidilT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6
VeratrineT46.5X1T46.5X2T46.5X3T46.5X4T46.5X5T46.5X6

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.