2027 ICD-10-CM Diagnosis Code T65.4X4SToxic effect of carbon disulfide, undetermined, sequela
T65.4X4S is a billable ICD-10-CM diagnosis code for toxic effect of carbon disulfide, undetermined, 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 Poisoning/toxic effect/adverse effects/underdosing, sequela.
Code Identity
Code Classification
Present on Admission (POA)Billing
T65.4X4S 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).
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 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 T65.4X4S: its own notes plus those printed at T65, 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 T65
- Ainitial encounter
- Dsubsequent encounter
- Ssequela this code
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
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.
| Substance | Accidental | Self-harm | Assault | Undetermined | Adverse Effect | Underdosing |
|---|---|---|---|---|---|---|
| Carbon::bisulfide (liquid) | T65.4X1 | T65.4X2 | T65.4X3 | T65.4X4 | – | – |
| Carbon::bisulfide (liquid)::vapor | T65.4X1 | T65.4X2 | T65.4X3 | T65.4X4 | – | – |
| Carbon::disulfide (liquid) | T65.4X1 | T65.4X2 | T65.4X3 | T65.4X4 | – | – |
| Carbon::disulfide (liquid)::vapor | T65.4X1 | T65.4X2 | T65.4X3 | T65.4X4 | – | – |
| Varnish | T65.4X1 | T65.4X2 | T65.4X3 | T65.4X4 | – | – |
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 T65.4X4S to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About T65.4X4SOverview
What is the ICD-10 code for toxic effect of carbon disulfide, undetermined, sequela?
The ICD-10-CM code for toxic effect of carbon disulfide, undetermined, sequela is T65.4X4S (sometimes written as T654X4S). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is T65.4X4S (Toxic effect of carbon disulfide, undetermined) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report toxic effect of carbon disulfide, undetermined, sequela on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What does the 7th character S in T65.4X4S mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the toxic effect of carbon disulfide, undetermined itself has resolved, not the original event.
What MS-DRG does T65.4X4S group to?
When toxic effect of carbon disulfide, undetermined, 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 T65.4X4S 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 carbon disulfide, undetermined, 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.
