2027 ICD-10-CM Diagnosis Code T64.02XSToxic effect of aflatoxin, intentional self-harm, sequela
T64.02XS is a billable ICD-10-CM diagnosis code for toxic effect of aflatoxin, 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 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 922 through 923. The code is exempt from POA reporting. 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.
T64.02XS no longer risk-adjusts for Medicare Advantage: it mapped to HCC 59 under the retired CMS-HCC V24 model through payment year 2025 but maps to no category in the live V28 model. It still risk-adjusts in the PACE (CMS-HCC V22) category 58, ESRD (V21) category 58, and ESRD (V24) category 59 for payment year 2027.
Code Identity
Code Classification
Present on Admission (POA)Billing
T64.02XS is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Toxic effects of substances chiefly nonmedicinal as to source (T51-T65).
Medicare Risk Adjustment (HCC)Billing
T64.02XS no longer risk-adjusts for Medicare Advantage: it maps to no payment category in the live CMS-HCC V28 model, although it still risk-adjusts in the other CMS models shown below.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Coding GuidelinesGuidance
The appropriate 7th character is to be added to each code from block Toxic effect of aflatoxin and other mycotoxin food contaminants (T64). 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 2027, published by CMS and the National Center for Health Statistics.
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to T64.02XS: its own notes plus those printed at T64, block T51-T65, and Chapter 19. A note printed at a category, block or chapter applies to every code under it.
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
- contact with and (suspected) exposure to toxic substances (Z77.-)
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code to identify any retained foreign body, if applicable (Z18.-)
Notes
General instructions on how these codes are used.
- When no intent is indicated code to accidental. Undetermined intent is only for use when there is specific documentation in the record that the intent of the toxic effect cannot be determined.
- Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
- The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.
7th Character
Every code in the category takes a 7th character from the listed values, with the placeholder X filling any empty positions before it.
- The appropriate 7th character is to be added to each code from category T64
- Ainitial encounter
- Dsubsequent encounter
- Ssequela this code
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name T64.02XS, its category, or a range that includes it.
Excludes1 2
These codes carry an Excludes1 note naming T64.02XS: they are not reported together with it, unless the two conditions are unrelated.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Aflatoxins
furano-furano-benzopyrans that are produced by aspergillus from sterigmatocystin. they are structurally related to coumarins and easily oxidized to an epoxide form to become alkylating agents. members of the group include aflatoxin b1; aflatoxin b2, aflatoxin g1, aflatoxin g2; aflatoxin m1; and aflatoxin m2.
Table of Drugs and ChemicalsClinical
Patient EducationClinical
Molds
Molds are fungi that can be found both outdoors and indoors. They grow best in warm, damp and humid conditions. If you have damp or wet spots in your house, you will probably get mold.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert T64.02XS to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About T64.02XSOverview
What is the ICD-10 code for toxic effect of aflatoxin, intentional self-harm, sequela?
The ICD-10-CM code for toxic effect of aflatoxin, intentional self-harm, sequela is T64.02XS (sometimes written as T6402XS). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is T64.02XS (Toxic effect of aflatoxin, intentional self-harm) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report toxic effect of aflatoxin, intentional self-harm, sequela on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What does the 7th character S in T64.02XS mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the toxic effect of aflatoxin, intentional self-harm itself has resolved, not the original event.
What MS-DRG does T64.02XS group to?
When toxic effect of aflatoxin, intentional self-harm, sequela is the principal diagnosis on an inpatient stay, it groups to MS-DRG 923, 922, with relative weights from 0.9980 to 1.6248 depending on complications. Higher weights mean higher Medicare reimbursement.
Is T64.02XS 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 toxic effect of aflatoxin, intentional self-harm, sequela on inpatient claims. The code appears in the Toxic effects of substances chiefly nonmedicinal as to source (T51-T65) range of the CMS exempt list.
Does T64.02XS risk-adjust for Medicare Advantage payment?
Not for Medicare Advantage. T64.02XS mapped to HCC 59 in the retired CMS-HCC V24 model, which last determined payment in 2025, but it maps to no category in the live V28 model; see all codes that no longer risk-adjust. It still risk-adjusts in the PACE (CMS-HCC V22) category 58 (Major Depressive/Bipolar/and Paranoid Disorders), ESRD (V21) category 58 (Major Depressive/Bipolar/and Paranoid Disorders), and ESRD (V24) category 59 (Major Depressive/Bipolar/and Paranoid Disorders).
