2024 ICD-10-CM Diagnosis Code T63.461A

Toxic effect of venom of wasps, accidental (unintentional), initial encounter

ICD-10-CM Code:
T63.461A
ICD-10 Code for:
Toxic effect of venom of wasps, accidental, init
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)
    • Toxic effects of substances chiefly nonmedicinal as to source
      (T51-T65)
      • Toxic effect of contact with venomous animals and plants
        (T63)

T63.461A is a billable diagnosis code used to specify a medical diagnosis of toxic effect of venom of wasps, accidental (unintentional), initial 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.

T63.461A is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like toxic effect of venom of wasps accidental (unintentional). According to ICD-10-CM Guidelines an "initial encounter" doesn't necessarily means "initial visit". The 7th character should be used when the patient is undergoing active treatment regardless if new or different providers saw the patient over the course of a treatment. The appropriate 7th character codes should also be used even if the patient delayed seeking treatment for a condition.

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Allergic reaction caused by hymenoptera venom
  • Allergic reaction caused by hymenoptera venom
  • Allergic reaction caused by insect bite and/or insect sting
  • Allergic reaction caused by insect bite and/or insect sting
  • Allergic reaction to wasp sting
  • Allergic reaction to wasp sting
  • Anaphylaxis caused by insect bite and/or insect sting
  • Anaphylaxis caused by insect venom
  • Anaphylaxis caused by venom
  • Anaphylaxis due to hymenoptera venom
  • Hymenoptera sting
  • Insect sting
  • Late effect of accidental injury
  • Late effect of accidental injury
  • Poisoning by wasp sting
  • Wasp sting
  • Wasp sting-induced anaphylaxis

Clinical Classification

Clinical CategoryCCSR Category CodeInpatient Default CCSROutpatient Default CCSR
External cause codes: bites; initial encounterEXT012N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis.N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.
External cause codes: intent of injury, accidental/unintentionalEXT020N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis.N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.
Toxic effects, initial encounterINJ023Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

Coding Guidelines

The appropriate 7th character is to be added to each code from block Toxic effect of contact with venomous animals and plants (T63). Use the following options for the aplicable episode of care:

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

Convert T63.461A to ICD-9-CM

  • ICD-9-CM Code: 989.5 - Toxic effect venom
    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: E905.3 - Hornet/wasp/bee sting
    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 T63.461 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
Wasp (sting)T63.461T63.462T63.463T63.464  

Patient Education


Insect Bites and Stings

Most insect bites are harmless, though they sometimes cause discomfort. Bee, wasp, and hornet stings and fire ant bites usually hurt. Mosquito and flea bites usually itch. Insects can also spread diseases. In the United States, some mosquitoes spread West Nile virus. Travelers outside the United States may be at risk for malaria and other infections.

To prevent insect bites and their complications:

  • Don't bother insects
  • Use insect repellant
  • Wear protective clothing
  • Be careful when you eat outside because food attracts insects
  • If you know you have severe allergic reactions to insect bites and stings (such as anaphylaxis), carry an emergency epinephrine kit

[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.