2024 ICD-10-CM Diagnosis Code T65.291A

Toxic effect of other tobacco and nicotine, accidental (unintentional), initial encounter

ICD-10-CM Code:
T65.291A
ICD-10 Code for:
Toxic effect of tobacco and nicotine, 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 other and unspecified substances
        (T65)

T65.291A is a billable diagnosis code used to specify a medical diagnosis of toxic effect of other tobacco and nicotine, 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.

T65.291A 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 other tobacco and nicotine 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:

  • Accidental nicotine overdose
  • Accidental nicotine poisoning
  • Accidental poisoning by cholinergic
  • Accidental poisoning by cholinergic
  • Adverse drug interaction
  • Adverse drug interaction with tobacco
  • Drug interaction with tobacco
  • Drug interaction with tobacco
  • Nicotine overdose
  • Nicotine poisoning
  • Tobacco related optic neuropathy
  • Toxic optic neuropathy

Clinical Classification

Clinical CategoryCCSR Category CodeInpatient Default CCSROutpatient Default CCSR
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.
External cause codes: poisoning by non-drugEXT015N - 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.

Clinical Information

  • Toxic Optic Neuropathy

    damage to the eye or its function (e.g., visual impairment) due to optic nerve damage secondary to toxic substances such as drugs used in chemotherapy; immunotherapy; or radiation.

Coding Guidelines

The appropriate 7th character is to be added to each code from block Toxic effect of other and unspecified substances (T65). Use the following options for the aplicable episode of care:

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

Convert T65.291A to ICD-9-CM

  • ICD-9-CM Code: 989.84 - Toxic effect of tobacco
    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: E866.8 - Acc pois-solid/liq NEC
    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 T65.291 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
Tobacco NECT65.291T65.292T65.293T65.294  
Tobacco NEC
  »cigarettes
T65.291T65.292T65.293T65.294  
Tobacco NEC
  »Indian
T65.291T65.292T65.293T65.294  
Tobacco NEC
  »smoke, second-hand
T65.291T65.292T65.293T65.294  

Patient Education


Smoking

What are the health effects of smoking?

There's no way around it; smoking is bad for your health. It harms nearly every organ of the body, some that you would not expect. Cigarette smoking causes nearly one in five deaths in the United States. It can also cause many other cancers and health problems. These include:

  • Cancers, including lung and oral cancers
  • Lung diseases, such as COPD (chronic obstructive pulmonary disease)
  • Damage to and thickening of blood vessels, which causes high blood pressure
  • Blood clots and stroke
  • Vision problems, such as cataracts and macular degeneration (AMD)

Women who smoke while pregnant have a greater chance of certain pregnancy problems. Their babies are also at higher risk of dying of sudden infant death syndrome (SIDS).

Smoking also causes addiction to nicotine, a stimulant drug that is in tobacco. Nicotine addiction makes it much harder for people to quit smoking.

What are the health risks of secondhand smoke?

Your smoke is also bad for other people - they breathe in your smoke secondhand and can get many of the same problems as smokers do. This includes heart disease and lung cancer. Children exposed to secondhand smoke have a higher risk of ear infections, colds, pneumonia, bronchitis, and more severe asthma. Mothers who breathe secondhand smoke while pregnant are more likely to have preterm labor and babies with low birth weight.

Are other forms of tobacco also dangerous?

Besides cigarettes, there are several other forms of tobacco. Some people smoke tobacco in cigars and water pipes (hookahs). These forms of tobacco also contain harmful chemicals and nicotine. Some cigars contain as much tobacco as an entire pack of cigarettes.

E-cigarettes often look like cigarettes, but they work differently. They are battery-operated smoking devices. Using an e-cigarette is called vaping. Not much is known about the health risks of using them. We do know they contain nicotine, the same addictive substance in tobacco cigarettes. E-cigarettes also expose non-smokers to secondhand aerosols (rather than secondhand smoke), which contain harmful chemicals.

Smokeless tobacco, such as chewing tobacco and snuff, is also bad for your health. Smokeless tobacco can cause certain cancers, including oral cancer. It also increases your risk of getting heart disease, gum disease, and oral lesions.

Why should I quit?

Remember, there is no safe level of tobacco use. Smoking even just one cigarette per day over a lifetime can cause smoking-related cancers and premature death. Quitting smoking can reduce your risk of health problems. The earlier you quit, the greater the benefit. Some immediate benefits of quitting include:

  • Lower heart rate and blood pressure
  • Less carbon monoxide in the blood (carbon monoxide reduces the blood's ability to carry oxygen)
  • Better circulation
  • Less coughing and wheezing

NIH National Cancer Institute


[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.