2024 ICD-10-CM Diagnosis Code T56.94

Toxic effect of unspecified metal, undetermined

ICD-10-CM Code:
T56.94
ICD-10 Code for:
Toxic effect of unspecified metal, undetermined
Is Billable?
Not Valid for Submission
Code Navigator:

Code Classification

  • Injury, poisoning and certain other consequences of external causes
    (S00–T88)
    • Toxic effects of substances chiefly nonmedicinal as to source
      (T51-T65)
      • Toxic effect of metals
        (T56)

T56.94 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of toxic effect of unspecified metal, undetermined. The code is not specific and is NOT valid for the year 2024 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.

Unspecified diagnosis codes like T56.94 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.

Specific Coding Applicable to Toxic effect of unspecified metal, undetermined

Non-specific codes like T56.94 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10-CM codes with a higher level of specificity when coding for toxic effect of unspecified metal, undetermined:

  • Use T56.94XA for initial encounter - BILLABLE CODE

  • Use T56.94XD for subsequent encounter - BILLABLE CODE

  • Use T56.94XS for sequela - BILLABLE CODE

Coding Guidelines

The appropriate 7th character is to be added to each code from block Toxic effect of metals (T56). Use the following options for the aplicable episode of care:

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

Table of Drugs and Chemicals

The 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
Metals (heavy) (nonmedicinal)T56.91T56.92T56.93T56.94  
Metals (heavy) (nonmedicinal)
  »dust, fumes, or vapor NEC
T56.91T56.92T56.93T56.94  
Metals (heavy) (nonmedicinal)
  »gadolinium
T56.91T56.92T56.93T56.94  
Metals (heavy) (nonmedicinal)
  »light NEC
T56.91T56.92T56.93T56.94  
Metals (heavy) (nonmedicinal)
  »light NEC
    »dust, fumes, or vapor NEC
T56.91T56.92T56.93T56.94  
Metals (heavy) (nonmedicinal)
  »specified NEC
T56.91T56.92T56.93T56.94  
Metals (heavy) (nonmedicinal)
  »thallium
T56.91T56.92T56.93T56.94  
Smelter fumes NECT56.91T56.92T56.93T56.94  

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.