2026 ICD-10-CM Diagnosis Code T65.4X2AToxic effect of carbon disulfide, intentional self-harm, initial encounter

ICD-10-CM CodesS00–T88T51-T65T65

ICD-10-CM T65.4X2A
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

T65.4X2A is a billable ICD-10-CM diagnosis code for toxic effect of carbon disulfide, intentional self-harm, initial encounter. The 7th character A marks it as an initial encounter code, used while the patient is receiving active treatment. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 917 through 918. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under External cause codes: intent of injury, self-harm; External cause codes: poisoning by non-drug; and Suicidal ideation/attempt/intentional self-harm.

Code Identity

ICD-10-CM Code
T65.4X2A
Billable Status
Yes — Valid for Submission
Code Describes
Toxic effect of carbon disulfide, intentional self-harm, initial encounter
Short Description
Toxic effect of carbon disulfide, self-harm, init
Parent Code
Toxic effect of carbon disulfide, intentional self-harm

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionT51-T65Toxic effects of substances chiefly nonmedicinal as to source
CategoryT65Toxic effect of other and unspecified substances
This CodeT65.4X2AToxic effect of carbon disulfide, intentional self-harm, initial encounter

Coding GuidelinesGuidance

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 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.

CCSR EXT021
External cause codes: intent of injury, self-harm
Default principal diagnosis: inpatient No · outpatient No
CCSR EXT015
External cause codes: poisoning by non-drug
Default principal diagnosis: inpatient No · outpatient No
CCSR MBD012
Suicidal ideation/attempt/intentional self-harm
Default principal diagnosis: inpatient Yes · outpatient Yes
CCSR INJ023
Toxic effects, initial encounter
Default principal diagnosis: inpatient No · outpatient No

Clinical InformationClinical

  • Alcohol Oxidoreductases

    a subclass of enzymes which includes all dehydrogenases acting on primary and secondary alcohols as well as hemiacetals. they are further classified according to the acceptor which can be nad+ or nadp+ (subclass 1.1.1), cytochrome (1.1.2), oxygen (1.1.3), quinone (1.1.5), or another acceptor (1.1.99).
  • Bicarbonates

    inorganic salts that contain the -hco3 radical. they are an important factor in determining the ph of the blood and the concentration of bicarbonate ions is regulated by the kidney. levels in the blood are an index of the alkali reserve or buffering capacity.
  • Blood Gas Monitoring, Transcutaneous

    the noninvasive measurement or determination of the partial pressure (tension) of oxygen and/or carbon dioxide locally in the capillaries of a tissue by the application to the skin of a special set of electrodes. these electrodes contain photoelectric sensors capable of picking up the specific wavelengths of radiation emitted by oxygenated versus reduced hemoglobin.
  • Calcium Carbonate

    carbonic acid calcium salt (caco3). an odorless, tasteless powder or crystal that occurs in nature. it is used therapeutically as a phosphate buffer in hemodialysis patients and as a calcium supplement.
  • Carbon

    a nonmetallic element with atomic symbol c, atomic number 6, and atomic weight [12.0096; 12.0116]. it may occur as several different allotropes including diamond; charcoal; and graphite; and as soot from incompletely burned fuel.
  • Carbon Compounds, Inorganic

    inorganic compounds that contain carbon as an integral part of the molecule but are not derived from hydrocarbons.
  • Carbon Cycle

    the cycle by which the element carbon is exchanged between organic matter and the earth's physical environment.
  • Carbon Dioxide

    a colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals.
  • Carbon Disulfide

    a colorless, flammable, poisonous liquid, cs2. it is used as a solvent, and is a counterirritant and has local anesthetic properties but is not used as such. it is highly toxic with pronounced cns, hematologic, and dermatologic effects.
  • Carbon Fiber

    fiber with a diameter of approximately 5 to 10 micrometers that is composed mostly of carbon atoms. it has a variety of applications.
  • Carbon Footprint

    a measure of the total greenhouse gas emissions produced by an individual, organization, event, or product. it is measured in units of equivalent kilograms of carbon dioxide generated in a given time frame.
  • Carbon Isotopes

    stable carbon atoms that have the same atomic number as the element carbon but differ in atomic weight. c-13 is a stable carbon isotope.
  • Carbon Monoxide

    carbon monoxide (co). a poisonous colorless, odorless, tasteless gas. it combines with hemoglobin to form carboxyhemoglobin, which has no oxygen carrying capacity. the resultant oxygen deprivation causes headache, dizziness, decreased pulse and respiratory rates, unconsciousness, and death. (from merck index, 11th ed)
  • Carbon Monoxide Poisoning

    toxic asphyxiation due to the displacement of oxygen from oxyhemoglobin by carbon monoxide.
  • Carbon Radioisotopes

    unstable isotopes of carbon that decay or disintegrate emitting radiation. c atoms with atomic weights 10, 11, and 14-16 are radioactive carbon isotopes.
  • Carbon Sequestration

    any of several processes for the permanent or long-term artificial or natural capture or removal and storage of carbon dioxide and other forms of carbon, through biological, chemical or physical processes, in a manner that prevents it from being released into the atmosphere.
  • Carbon Tetrachloride

    a solvent for oils, fats, lacquers, varnishes, rubber waxes, and resins, and a starting material in the manufacturing of organic compounds. poisoning by inhalation, ingestion or skin absorption is possible and may be fatal. (merck index, 11th ed)
  • Carbon Tetrachloride Poisoning

    poisoning that results from ingestion, injection, inhalation, or skin absorption of carbon tetrachloride.
  • Carbon-13 Magnetic Resonance Spectroscopy

    magnetic resonance spectroscopy involving detection of changes in the resonance of carbon-13 nuclei in organic molecules.
  • Carbonated Beverages

    drinkable liquids combined with or impregnated with carbon dioxide.
  • Carbonated Water

    water naturally or artificially infused with carbon dioxide.
  • Carbonates

    salts or ions of the theoretical carbonic acid, containing the radical co2(3-). carbonates are readily decomposed by acids. the carbonates of the alkali metals are water-soluble; all others are insoluble. (from grant & hackh's chemical dictionary, 5th ed)
  • Carbon-Carbon Double Bond Isomerases

    enzymes that catalyze the shifting of a carbon-carbon double bond from one position to another within the same molecule. ec 5.3.3.
  • Carbon-Carbon Ligases

    enzymes that catalyze the joining of two molecules by the formation of a carbon-carbon bond. these are the carboxylating enzymes and are mostly biotinyl-proteins. ec 6.4.
  • Carbon-Carbon Lyases

    enzymes that catalyze the cleavage of a carbon-carbon bond by means other than hydrolysis or oxidation. this subclass contains the decarboxylases, the aldehyde-lyases, and the oxo-acid-lyases. ec 4.1.
  • Carbonic Acid

    carbonic acid (h2c03). the hypothetical acid of carbon dioxide and water. it exists only in the form of its salts (carbonates), acid salts (hydrogen carbonates), amines (carbamic acid), and acid chlorides (carbonyl chloride). (from grant & hackh's chemical dictionary, 5th ed)
  • Carbonic Anhydrase I

    a cytosolic carbonic anhydrase isoenzyme primarily expressed in erythrocytes, vascular endothelial cells, and the gastrointestinal mucosa. ec 4.2.1.-
  • Carbonic Anhydrase II

    a cytosolic carbonic anhydrase isoenzyme found widely distributed in cells of almost all tissues. deficiencies of carbonic anhydrase ii produce a syndrome characterized by osteopetrosis, renal tubular acidosis (acidosis, renal tubular) and cerebral calcification. ec 4.2.1.-
  • Carbonic Anhydrase III

    a cytosolic carbonic anhydrase isoenzyme primarily expressed in skeletal muscle (muscles, skeletal). ec 4.2.1.-
  • Carbonic Anhydrase Inhibitors

    a class of compounds that reduces the secretion of h+ ions by the proximal kidney tubule through inhibition of carbonic anhydrases.
  • Carbonic Anhydrase IV

    a membrane-bound carbonic anhydrase found in lung capillaries and kidney.
  • Carbonic Anhydrase IX

    a carbonic anhydrase and transmembrane protein that consists of an n-terminal proteoglycan-like domain, a catalytic region, a single-pass transmembrane domain, and a short intracellular tail. it functions as a dimer and is expressed primarily by cells of the gastrointestinal tract; bile duct epithelium; and gall bladder. it is expressed at high levels in many solid tumors, especially clear cell renal carcinoma, in response to cell hypoxia.
  • Carbonic Anhydrase V

    a carbonic anhydrase isoenzyme found in mitochondria where it provides bicarbonate ions that are components in the urea cycle and in gluconeogenesis.
  • Carbonic Anhydrases

    a family of zinc-containing enzymes that catalyze the reversible hydration of carbon dioxide. they play an important role in the transport of carbon dioxide from the tissues to the lung. ec 4.2.1.1.
  • Carbon-Nitrogen Ligases

    enzymes that catalyze the joining of two molecules by the formation of a carbon-nitrogen bond. ec 6.3.
  • Carbon-Nitrogen Ligases with Glutamine as Amide-N-Donor

    enzymes that catalyze the joining of glutamine-derived ammonia and another molecule. the linkage is in the form of a carbon-nitrogen bond. ec 6.3.5.
  • Carbon-Nitrogen Lyases

    enzymes that catalyze the cleavage of a carbon-nitrogen bond by means other than hydrolysis or oxidation. subclasses are the ammonia-lyases, the amidine-lyases, the amine-lyases, and other carbon-nitrogen lyases. ec 4.3.
  • Carbon-Oxygen Ligases

    enzymes that catalyze the joining of two molecules by the formation of a carbon-oxygen bond. ec 6.1.
  • Carbon-Oxygen Lyases

    enzymes that catalyze the cleavage of a carbon-oxygen bond by means other than hydrolysis or oxidation. ec 4.2.
  • Carbon-Sulfur Ligases

    enzymes that catalyze the joining of two molecules by the formation of a carbon-sulfur bond. ec 6.2.
  • Carbon-Sulfur Lyases

    enzymes that catalyze the cleavage of a carbon-sulfur bond by means other than hydrolysis or oxidation. ec 4.4.
  • Carbonyl Cyanide m-Chlorophenyl Hydrazone

    a proton ionophore. it is commonly used as an uncoupling agent and inhibitor of photosynthesis because of its effects on mitochondrial and chloroplast membranes.
  • Carbonyl Cyanide p-Trifluoromethoxyphenylhydrazone

    a proton ionophore that is commonly used as an uncoupling agent in biochemical studies.
  • Carbonyl Reductase (NADPH)

    nadph-dependent reductase that catalyzes the reduction of many carbonyl compounds including quinones; prostaglandins; and xenobiotics.
  • Carboxyhemoglobin

    enzymes that catalyze the addition of a carboxyl group to a compound (carboxylases) or the removal of a carboxyl group from a compound (decarboxylases). ec 4.1.1.
  • Catabolite Repression

    process by which micro-organisms adapt quickly to a preferred rapidly-metabolizable intermediate through the inhibition or repression of genes related to catabolism of less preferred source(s).
  • Dissolved Organic Matter

    a heterogeneous class of water-soluble compounds containing covalently bound carbon that are derived from a variety of biological and geological sources during the biogeochemical cycling of carbon (carbon cycle).
  • Dry Ice

    a solid form of carbon dioxide used as a refrigerant.
  • Heavy Ion Radiotherapy

    the use of a heavy ion particle beam for radiotherapy, such as the heavy ions of carbon.
  • Iron Carbonyl Compounds

    complexes of iron atoms chelated with carbonyl ions.
  • Lasers, Gas

    lasers in which a gas lasing medium is stimulated to emit light by an electric current or high-frequency oscillator.
  • Lithium Carbonate

    a lithium salt, classified as a mood-stabilizing agent. lithium ion alters the metabolism of biogenic monoamines in the central nervous system, and affects multiple neurotransmission systems.
  • Meteoroids

    any solid objects moving in interplanetary space that are smaller than a planet or asteroid but larger than a molecule. meteorites are any meteoroid that has fallen to a planetary surface. (from mcgraw-hill dictionary of scientific and technical terms, 4th ed)
  • Nanotubes, Carbon

    nanometer-sized tubes composed mainly of carbon. such nanotubes are used as probes for high-resolution structural and chemical imaging of biomolecules with atomic force microscopy.
  • Photosynthesis

    the synthesis by organisms of organic chemical compounds, especially carbohydrates, from carbon dioxide using energy obtained from light rather than from the oxidation of chemical compounds. photosynthesis comprises two separate processes: the light reactions and the dark reactions. in higher plants; green algae; and cyanobacteria; nadph and atp formed by the light reactions drive the dark reactions which result in the fixation of carbon dioxide. (from oxford dictionary of biochemistry and molecular biology, 2001)
  • Pregnenolone Carbonitrile

    a catatoxic steroid and microsomal enzyme inducer having significant effects on the induction of cytochrome p450. it has also demonstrated the potential for protective capability against acetaminophen-induced liver damage.
  • Protein Carbonylation

    the appearance of carbonyl groups (such as aldehyde or ketone groups) in proteins as the result of several oxidative modification reactions. it is a standard marker for oxidative stress. carbonylated proteins tend to be more hydrophobic and resistant to proteolysis.
  • Radiometric Dating

    techniques used to determine the age of materials, based on the content and half-lives of the radioactive isotopes they contain.
  • Sevelamer

    a polymeric amine that binds phosphate and is used to treat hyperphosphatemia in patients with kidney disease.
  • Sodium Bicarbonate

    a white, crystalline powder that is commonly used as a ph buffering agent, an electrolyte replenisher, systemic alkalizer and in topical cleansing solutions.
  • Soot

    a dark powdery deposit of unburned fuel residues, composed mainly of amorphous carbon and some hydrocarbons, that accumulates in chimneys, automobile mufflers and other surfaces exposed to smoke. it is the product of incomplete combustion of carbon-rich organic fuels in low oxygen conditions. it is sometimes called lampblack or carbon black and is used in ink, in rubber tires, and to prepare carbon nanotubes.
  • Trioses

    monosaccharide molecules that contain a three carbon backbone.

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.

SubstanceAccidentalSelf-harmAssaultUndeter­minedAdverse
Effect
Under­dosing
CarbonT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::bisulfide (liquid)T65.4X1T65.4X2T65.4X3T65.4X4
Carbon::bisulfide (liquid)::vaporT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::dioxide (gas)T65.4X1T65.4X2T65.4X3T65.4X4
Carbon::dioxide (gas)::medicinalT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::dioxide (gas)::nonmedicinalT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::dioxide (gas)::snowT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::disulfide (liquid)T65.4X1T65.4X2T65.4X3T65.4X4
Carbon::disulfide (liquid)::vaporT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)T65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::blast furnace gasT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::butane (distributed in mobile container)T65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::butane (distributed in mobile container)::distributed through pipesT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::charcoal fumesT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::coalT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::coke (in domestic stoves, fireplaces)T65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::gas (piped)T65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::solid (in domestic stoves, fireplaces)T65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::exhaust gas (motor) not in transitT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::exhaust gas (motor) not in transit::combustion engine, any not in watercraftT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::exhaust gas (motor) not in transit::farm tractor, not in transitT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::exhaust gas (motor) not in transit::gas engineT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::exhaust gas (motor) not in transit::motor pumpT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::exhaust gas (motor) not in transit::motor vehicle, not in transitT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::fuel (in domestic use)T65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::fuel (in domestic use)::gas (piped)T65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::fuel (in domestic use)::gas (piped)::in mobile containerT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::fuel (in domestic use)::piped (natural)T65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::fuel (in domestic use)::utilityT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::fuel (in domestic use)::utility::in mobile containerT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::illuminating gasT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::industrial fuels or gases, anyT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::kerosene (in domestic stoves, fireplaces)T65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::kiln gas or vaporT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::motor exhaust gas, not in transitT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::piped gas (manufactured) (natural)T65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::producer gasT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::propane (distributed in mobile container)T65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::propane (distributed in mobile container)::distributed through pipesT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::specified source NECT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::stove gasT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::stove gas::pipedT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::utility gasT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::utility gas::pipedT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::water gasT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::monoxide (from incomplete combustion)::wood (in domestic stoves, fireplaces)T65.4X1T65.4X2T65.4X3T65.4X4
Carbon::tetrachloride (vapor) NECT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::tetrachloride (vapor) NEC::liquid (cleansing agent) NECT65.4X1T65.4X2T65.4X3T65.4X4
Carbon::tetrachloride (vapor) NEC::solventT65.4X1T65.4X2T65.4X3T65.4X4
VarnishT65.4X1T65.4X2T65.4X3T65.4X4
Varnish::cleanerT65.4X1T65.4X2T65.4X3T65.4X4

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 T65.4X2A to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
982.2 Toxic eff carbon disulfi
ApproximateCombination The match is approximate, and more than one code can be needed to describe the source diagnosis. Confirm with contextual judgment.
ICD-9-CM
E950.9 Poison-solid/liquid NEC
ApproximateCombination The match is approximate, and more than one code can be needed to describe the source diagnosis. Confirm with contextual judgment.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About T65.4X2AOverview

Is T65.4X2A (Toxic effect of carbon disulfide, intentional self-harm) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report toxic effect of carbon disulfide, intentional self-harm, initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character A in T65.4X2A mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for toxic effect of carbon disulfide, intentional self-harm, such as an emergency visit or first evaluation.

What MS-DRG does T65.4X2A group to?

When toxic effect of carbon disulfide, intentional self-harm, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 917, 918, with relative weights from 0.8571 to 1.5684 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of T65.4X2A?

Under the General Equivalence Mappings, toxic effect of carbon disulfide, intentional self-harm, initial encounter converts to ICD-9-CM 982.2 (toxic eff carbon disulfi) and E950.9 (poison-solid/liquid NEC). 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.