2026 ICD-10-CM Diagnosis Code T49.8X2SPoisoning by other topical agents, intentional self-harm, sequela
T49.8X2S is a billable ICD-10-CM diagnosis code for poisoning by other topical agents, 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 intentional spermicide poisoning. 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
Code Classification
Present on Admission (POA)Billing
T49.8X2S 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.
- Intentional spermicide poisoning
- Poisoning by spermicide
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 topical agents primarily affecting skin and mucous membrane and by ophthalmological, otorhinorlaryngological and dental drugs (T49). 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.
Clinical InformationClinical
Cosmetics
substances intended to be applied to the human body for cleansing, beautifying, promoting attractiveness, or altering the appearance without affecting the body's structure or functions. included in this definition are skin creams, lotions, perfumes, lipsticks, fingernail polishes, eye and facial makeup preparations, permanent waves, hair colors, toothpastes, and deodorants, as well as any material intended for use as a component of a cosmetic product. (u.s. food & drug administration center for food safety & applied nutrition office of cosmetics fact sheet (web page) feb 1995)Hair Preparations
hair grooming, cleansing and modifying products meant for topical application to hair, usually human. they include sprays, bleaches, dyes, conditioners, rinses, shampoos, nutrient lotions, etc.Acidosis, Lactic
acidosis caused by accumulation of lactic acid more rapidly than it can be metabolized. it may occur spontaneously or in association with diseases such as diabetes mellitus; leukemia; or liver failure.Lactic Acid
a normal intermediate in the fermentation (oxidation, metabolism) of sugar. the concentrated form is used internally to prevent gastrointestinal fermentation. (from stedman, 26th ed)Lactobacillales
an order of gram-positive bacteria in the class bacilli, that have the ability to ferment sugars to lactic acid. they are widespread in nature and commonly used to produce fermented foods.Pyruvate Carboxylase Deficiency Disease
an autosomal recessive metabolic disorder caused by absent or decreased pyruvate carboxylase activity, the enzyme that regulates gluconeogenesis, lipogenesis, and neurotransmitter synthesis. clinical manifestations include lactic acidosis, seizures, respiratory distress, marked psychomotor delay, periodic hypoglycemia, and hypotonia. the clinical course may be similar to leigh disease. (from am j hum genet 1998 jun;62(6):1312-9)Pyruvate Dehydrogenase Complex Deficiency Disease
an inherited metabolic disorder caused by deficient enzyme activity in the pyruvate dehydrogenase complex, resulting in deficiency of acetyl coa and reduced synthesis of acetylcholine. two clinical forms are recognized: neonatal and juvenile. the neonatal form is a relatively common cause of lactic acidosis in the first weeks of life and may also feature an erythematous rash. the juvenile form presents with lactic acidosis, alopecia, intermittent ataxia; seizures; and an erythematous rash. (from j inherit metab dis 1996;19(4):452-62) autosomal recessive and x-linked forms are caused by mutations in the genes for the three different enzyme components of this multisubunit pyruvate dehydrogenase complex. one of the mutations at xp22.2-p22.1 in the gene for the e1 alpha component of the complex leads to leigh disease.Podophyllotoxin
a lignan (lignans) found in podophyllin resin from the roots of podophyllum plants. it is a potent spindle poison, toxic if taken internally, and has been used as a cathartic. it is very irritating to skin and mucous membranes, has keratolytic actions, has been used to treat warts and keratoses, and may have antineoplastic properties, as do some of its congeners and derivatives.
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.
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 T49.8X2S to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About T49.8X2SOverview
Is T49.8X2S (Poisoning by other topical agents, intentional self-harm) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report poisoning by other topical agents, intentional self-harm, sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character S in T49.8X2S mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the poisoning by other topical agents, intentional self-harm itself has resolved, not the original event.
What MS-DRG does T49.8X2S group to?
When poisoning by other topical agents, 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 T49.8X2S 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 other topical agents, intentional self-harm, sequela on inpatient claims.
What is the ICD-9 equivalent of T49.8X2S?
Under the General Equivalence Mappings, poisoning by other topical agents, 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.
